乳腺癌保乳术中近距离瘤床放疗的临床应用评估

The clinical application of the intra-operative radiation for patients with breast cancer receiving breast-conserving surgery

目的:探讨早期乳腺癌保乳术中采用近距离瘤床放疗取代常规术后全乳放疗后瘤床加量外照射的安全性和可行性。方法:共入组30例患者,其中15例早期乳腺癌患者接受保乳术中近距离瘤床放疗,术后常规行全乳放疗;另选择15例早期乳腺癌患者作为配对,接受保乳手术及术后全乳和瘤床加量放疗。比较2组患者术后24～48h残腔引流量、切口Ⅰ期愈合率、术后住院天数和乳房外形满意度。结果:研究组与对照组的术后24～48h残腔引流量、切口Ⅰ期愈合率、平均住院天数及辅助化疗开始时间的差异均无统计学意义(P>0.05)。2组患者的短期随访结果显示,均能保持满意的乳房外形。结论:早期乳腺癌保乳术中近距离瘤床放疗具有较好的安全性和临床可操作性。

Objective： To evaluate the safety and operablility of intra-operative radiotherapy plus post-operative whole breast radiotherapy instead of post-operative who（e breast radiotherapy with a boost to the tumor bed in patients with early-stage breast cancer patients receiving breast-conserving surgery. Methods： A total of 30 patients with early-stage breast cancer were included in this study, and they received breast-conserving surgery plus intra-operative radiotherapy and post-operative whole breast radiotherapy （n = 15, study group） or breast-conserving surgery plus post-operative whole breast radiotherapy with a boost to the tumor bed （n = 15, control group）. The clinical measurements including the external drainage of residual cavity in 24-48 h, first stage of wound healing, duration of hospitalization, satisfaction with breast shape and the interval between breast-conserving surgery and the chemotherapy were compared between the two groups. Results： There were no significant differences between the two groups in external drainage of residual cavity, first stage of wound healing duration of hospitalization and the interval between breast-conserving surgery and the chemotherapy （P〉O.05）. The short-term follow-up revealed that the patients in both two groups kept breast in good shape. Conclusion： Intra-operative radiotherapy is safe and operable in patients with early-stage breast cancer receiving breast-conserving surgery.