摘要
目的:初步探讨INTRABEAM术中放疗(IORT)辅助下早期乳腺癌保乳根治术的可行性和安全性。方法:选择2012年11月—2013年7月期间符合入组条件的17例女性早期乳腺癌患者,患者均行IORT辅助下保乳根治术。观察患者术后手术部位的情况,局部并发症以及急性放射损伤的发生率;通过门诊随访方式评判乳房美容效果并分析近期疗效。结果:所有患者均完成IORT辅助下保乳根治术,术中照射的中位数时间为25(20~35)min。4例患者(23.5%)术后需接受全乳房外照射。术后的早期并发症主要包括残腔积液较多(11.8%),较明显的皮肤红肿(17.6%)。无明显残腔血肿或者伤口感染病例,患者对术中放疗的耐受性良好。早期随访显示,患侧乳房术后的美容效果优良率76.5%,无复发生存率、无转移生存率、总生存率均为100%。结论:IORT辅助下保乳根治术用于特定的早期乳腺癌患者是相对安全可行的。
Objective: To investigate the feasibility and safety of breast conserving surgery for early-stage breast cancer with the assistance of INTA BEAM intraoperative radiotherapy(IORT).Methods: Seventeen eligible female patients with early-stage breast cancer were enrolled from November 2012 to July 2013, and all of them underwent IORT-assisted radical breast conserving surgery. The surgical site condition, incidence of local complications and acute radiation injury in the patients were observed after surgery, and the cosmetic results of the breast and short-term therapeutic efficacy were assessed through follow-up clinical visits.Results: IORT-assisted radical breast conserving surgery was completed in all patients with a median intraoperative irradiation time of 25(20–35) min. Four patients(23.5%) needed external whole-breast irradiation after operation. The main early postoperative complications included excessive fluid in the residual dead space(11.8%), and evident redness and swelling of the skin of the breast(17.6%). No evident hematoma in the residual dead space or wound infection was noted in any of the patients, and all patients tolerated the intraoperative irradiation well. The early follow-up survey showed that the good cosmetic rate of the affected breast after surgery was 76.5%, and there was 100% rate of relapse-free survival, metastasisfree survival and overall survival. Conclusion: IORT-assisted radical breast conserving surgery is relatively safe and reliable for selected patients with early-stage breast cancer.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第11期1467-1471,共5页
China Journal of General Surgery