早期乳腺癌保乳手术联合术中放疗研究进展

The progress of breast conserving surgery combined with intraoperative radiotherapy for early stage breast cancer

目前乳腺癌的发病率居国内外女性恶性肿瘤之首，发病年龄趋于年轻化。由于保乳术后肿瘤残腔的局部改变，传统的保乳手术联合全乳及瘤床加量外照射无法精确定位且整个疗程较长。采用术中放疗（intra-operative radiation therapy，IORT）能很好地避免呼吸运动及体位改变带来的影响，并在术中即刻对瘤床进行精确照射。对患者而言，IORT缩短放疗周期并减少对皮肤和皮下组织的照射，从而使IORT具有方便、易接受、并发症相对较少、美容效果好等优点。近年来，对早期乳腺癌的保乳治疗越来越多的肿瘤防治中心采用保乳手术联合IORT的方式并对术中放疗的适应证、方式、剂量、疗效及预后做了相关研究。

Currently, the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger. Due to the local changes of the tumor residual cavity after the breast conserving surgery, we can＇t accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount, and the course of treatment is longer. Intra-operative radiation therapy （IORT） can avoid the impact of respiratory motion and postural changes. Meanwhile, it can immediately irradiate the tumor bed intraoperative accurately. For patients, IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin arid subcutaneous tissue. So IORT is convenient, easy to be accepted, and it has relatively few complications, good cosmetic results and so on. In recent years, more and more Cancer Center choose breast conserving surgery combined with IORT for the treatment of early stage breast cancer and do researches to the indications, methods, dosage, efficacy and prognosis of IORT.