METHODS: IORT was given as APBI in 58 patients (IORT/APBI-group) and as a boost in 198 patients (IORT/WBRT-group). A median dose of 20 Gy was given intraoperatively with low energy X-rays [INTRABEAM (TM) System] and additionally 46 Gy/2 Gy per fraction to the whole breast, if WBRT was added. Blood counts were collected preoperatively, after 90 days and through year 1-5 of follow-up. Dunnett\'s tests were used to calculate changes in blood counts over time. Additionally, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and derived neutrophil-to-lymphocyte ratio (dNLR) were calculated for each time point.
RESULTS: Significantly decreases in the IORT/WBRT-group were seen for erythrocytes, hemoglobin, platelets and leucocytes and an increase for lymphocytes for the total follow-up period. In the IORT/APBI-group significantly decreases were seen for erythrocytes and hemoglobin for the total follow-up period. Regarding changes during follow-up compared to the preoperative value, much more significant changes were seen in the IORT/WBRT-group compared to IORT/APBI-group without any relevant impact of chemotherapy. Regarding PLR-, NLR- and dNLR-values the rate of patients over the range improved over time in both groups.
CONCLUSIONS: IORT/APBI seems to have a smaller effect on blood counts compared to IORT/WBRT. Furthermore, PLR-, NLR- and dNLR-values improved over time, suggesting a positive effect on outcome after IORT in general.
方法:在58例患者(IORT/APBI组)中以APBI的形式给予IORT,在198例患者(IORT/WBRT组)中给予加强。术中使用低能量X射线[INTRABEAM(TM)系统]给予20Gy的中位剂量,另外对整个乳房每部分给予46Gy/2Gy,如果添加了WBRT。术前收集血细胞计数,90天后和随访1-5年。Dunnett的测试用于计算血液计数随时间的变化。此外,血小板与淋巴细胞比率(PLR),计算每个时间点的中性粒细胞与淋巴细胞比率(NLR)和衍生中性粒细胞与淋巴细胞比率(dNLR).
结果:在IORT/WBRT组中观察到红细胞明显减少,血红蛋白,在整个随访期间,血小板和白细胞以及淋巴细胞的增加。在整个随访期间,在IORT/APBI组中,红细胞和血红蛋白显着下降。关于随访期间与术前相比的变化,与无任何相关化疗影响的IORT/APBI组相比,IORT/WBRT组的变化更为显著.关于PLR-,NLR和dNLR值两组患者在该范围内的比率随时间改善。
结论:与IORT/WBRT相比,IORT/APBI似乎对血细胞计数的影响较小。此外,PLR-,随着时间的推移,NLR和dNLR值有所改善,表明总体上对IORT后的结果有积极影响。