Abstract：
BACKGROUND: 85-90% of local recurrences after breastconserving surgery occurs within the index quadrant. Intraoperative radiotherapy may be a good alternative for eligible patients avoiding long course of adjuvant radiation.
METHODS: Eligible patients were early stage node negative at least 50 years at time of inclusion, unicentric less than 30mm in diameter any hormone receptor status. 21 Gy was delivered intraoperatively, biologically equivalent to 58 to 60 Gy in standard fractionation using electron beam to 90% isodose line. Cosmetic, Oncological and Patient Satisfaction Evaluation of treated Patients between March 2018 and August 2020 at the King Khalid university hospital, using the IOeRT (Mobetron® ). Evaluation done at a combined clinic between surgical and radiation oncology teams at the end of the follow up period before publication.
RESULTS: 15 female patients were evaluable with mean follow up period 33.8 months (19-48 months). Mean Age 56.4 years (50-65 years). Mean tumor size 1.213 cm. Majority of patients were T1. 2 patients showed Sentinel lymph node positive.21 Gy was delivered intraoperatively.4 Patients (26.7%) received adjuvant postoperative external beam radiation therapy (EBRT). 2 patients due to being in Caution group due to positive extensive Ductal carcinoma in situ (DCIS). External beam radiation was 40 Gy/15 fractions/3 weeks using three dimensional radiation therapy (3DCRT). Cosmetically, Apart from one patient score 9 due to presence of keloid scar formation, most patients were in range of 0-3 according to physician evaluation and Modified Hollander\'s score otherwise, No more than score 3 in any of the patients was detected. Oncologically, Till the time of publication no local or distant relapses was detected. As a patient experience, 100 % of patients were satisfied.
CONCLUSIONS: Breast IOERT is a convenient, safe and a valid treatment modality as an option for patients who are otherwise appropriate candidates for APBI. Proper patient selection should focus on clinicopathologic factors predictive of negative nodes and negative margins. Careful assessment of preoperative mammographic and other imaging studies for features, such as extent of calcifications, may be helpful.
METHODS: Eligible patients were early stage node negative at least 50 years at time of inclusion, unicentric less than 30mm in diameter any hormone receptor status. 21 Gy was delivered intraoperatively, biologically equivalent to 58 to 60 Gy in standard fractionation using electron beam to 90% isodose line. Cosmetic, Oncological and Patient Satisfaction Evaluation of treated Patients between March 2018 and August 2020 at the King Khalid university hospital, using the IOeRT (Mobetron® ). Evaluation done at a combined clinic between surgical and radiation oncology teams at the end of the follow up period before publication.
RESULTS: 15 female patients were evaluable with mean follow up period 33.8 months (19-48 months). Mean Age 56.4 years (50-65 years). Mean tumor size 1.213 cm. Majority of patients were T1. 2 patients showed Sentinel lymph node positive.21 Gy was delivered intraoperatively.4 Patients (26.7%) received adjuvant postoperative external beam radiation therapy (EBRT). 2 patients due to being in Caution group due to positive extensive Ductal carcinoma in situ (DCIS). External beam radiation was 40 Gy/15 fractions/3 weeks using three dimensional radiation therapy (3DCRT). Cosmetically, Apart from one patient score 9 due to presence of keloid scar formation, most patients were in range of 0-3 according to physician evaluation and Modified Hollander\'s score otherwise, No more than score 3 in any of the patients was detected. Oncologically, Till the time of publication no local or distant relapses was detected. As a patient experience, 100 % of patients were satisfied.
CONCLUSIONS: Breast IOERT is a convenient, safe and a valid treatment modality as an option for patients who are otherwise appropriate candidates for APBI. Proper patient selection should focus on clinicopathologic factors predictive of negative nodes and negative margins. Careful assessment of preoperative mammographic and other imaging studies for features, such as extent of calcifications, may be helpful.
摘要：
背景：保乳手术后85-90％的局部复发发生在指数象限内。对于符合条件的患者，术中放疗可能是一种很好的选择，可以避免长时间的辅助放疗。
方法：符合条件的患者在纳入时至少50年为早期淋巴结阴性，单中心直径小于30mm的任何激素受体状态。术中分娩21Gy，在标准分级分离中，使用电子束到90％等剂量线的生物学当量为58至60Gy。化妆品,2018年3月至2020年8月在哈立德国王大学医院接受治疗的患者的肿瘤和患者满意度评估，使用IOeRT(Mobetron®)。在发表前的随访期结束时，在外科和放射肿瘤学团队之间的联合诊所进行评估。
结果：15例女性患者平均随访33.8个月（19-48个月）。平均年龄56.4岁（50-65岁）。平均肿瘤大小1.213cm。大多数患者为T1。2例患者显示前哨淋巴结阳性。术中输送21Gy。4例患者(26.7%)接受术后辅助外束放射治疗(EBRT)。2例因广泛导管原位癌（DCIS）阳性而处于谨慎组。使用三维放射治疗（3DCRT），外部束辐射为40Gy/15分/3周。化妆品,除了一名患者因瘢痕疙瘩形成而得9分之外，根据医生评估，大多数患者在0-3的范围内，否则，在任何患者中检测到不超过3分。肿瘤学上，在发表之前，未检测到局部或远处复发。作为一个病人的经验，100%患者满意。
结论：乳腺IOERT是一种方便的，安全和有效的治疗方式作为一种选择，对于那些在其他方面适合接受APBI治疗的患者。正确的患者选择应关注预测阴性淋巴结和阴性边缘的临床病理因素。仔细评估术前乳房X线照相术和其他影像学检查的特征，比如钙化的程度，可能会有所帮助。
方法：符合条件的患者在纳入时至少50年为早期淋巴结阴性，单中心直径小于30mm的任何激素受体状态。术中分娩21Gy，在标准分级分离中，使用电子束到90％等剂量线的生物学当量为58至60Gy。化妆品,2018年3月至2020年8月在哈立德国王大学医院接受治疗的患者的肿瘤和患者满意度评估，使用IOeRT(Mobetron®)。在发表前的随访期结束时，在外科和放射肿瘤学团队之间的联合诊所进行评估。
结果：15例女性患者平均随访33.8个月（19-48个月）。平均年龄56.4岁（50-65岁）。平均肿瘤大小1.213cm。大多数患者为T1。2例患者显示前哨淋巴结阳性。术中输送21Gy。4例患者(26.7%)接受术后辅助外束放射治疗(EBRT)。2例因广泛导管原位癌（DCIS）阳性而处于谨慎组。使用三维放射治疗（3DCRT），外部束辐射为40Gy/15分/3周。化妆品,除了一名患者因瘢痕疙瘩形成而得9分之外，根据医生评估，大多数患者在0-3的范围内，否则，在任何患者中检测到不超过3分。肿瘤学上，在发表之前，未检测到局部或远处复发。作为一个病人的经验，100%患者满意。
结论：乳腺IOERT是一种方便的，安全和有效的治疗方式作为一种选择，对于那些在其他方面适合接受APBI治疗的患者。正确的患者选择应关注预测阴性淋巴结和阴性边缘的临床病理因素。仔细评估术前乳房X线照相术和其他影像学检查的特征，比如钙化的程度，可能会有所帮助。
