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Abstract：
Intraoperative radiotherapy (IORT) is an alternative for external beam radiotherapy (EBRT) for early stage breast cancer (BC). Herein, we compared outcomes, postoperative and post-radiation complications of IORT and EBRT.
We conducted a cohort study to compare complications of IORT and EBRT in patients. A checklist of the complications of IORT and EBRT, was used to assess and post-radiation complications and outcomes.
Overall, 264 women (121 in IORT and 143 in EBRT group) with a mean (SD) age of 55 ± 8.6 years analyzed in this study. The IORT group (quadrantectomy + SLNB + IORT) had more severe post-operative pain compared to the EBRT group (quadrantectomy + SLNB) (OR = 1.929, 95% CI: 1.116-3.332). Other postoperative complications, including edema, erythema, seroma, hematoma, and wound complications were not significantly different between the IORT and EBRT groups. EBRT was associated with higher rates post-radiation complications, including erythema (95.8% vs. 21.5%), skin dryness (30.8% vs. 12.4%), pruritus (26.6% vs. 17.4%), hyperpigmentation (48.3% vs. 9.9%), and telangiectasia (1.4% vs. 0.8%). Multivariate analysis showed that erythema, skin dryness and pruritus, and hyperpigmentation were more severe in the EBRT group, while breast induration was higher in the IORT group (OR = 4.109, 95% CI: 2.242-7.531). Excellent, good, and fair cosmetic outcome was seen in 11.2%, 72%, and 16.8% of the patients in the EBRT group and 29.8%, 63.6%, and 6.6% in the IORT group, respectively, suggesting that the cosmetic outcome was significantly better in the IORT group (P < .001). There wasn\'t statistically significant difference in recurrence-free survival and overall survival rates between two groups of patients who received either IORT or EBRT (P = .953, P = .56).
IORT is considered to have lower post-radiation complications and better cosmetic outcomes in breast cancer patients. Therefore, IORT might be used as the treatment of choice in eligible patients.
We conducted a cohort study to compare complications of IORT and EBRT in patients. A checklist of the complications of IORT and EBRT, was used to assess and post-radiation complications and outcomes.
Overall, 264 women (121 in IORT and 143 in EBRT group) with a mean (SD) age of 55 ± 8.6 years analyzed in this study. The IORT group (quadrantectomy + SLNB + IORT) had more severe post-operative pain compared to the EBRT group (quadrantectomy + SLNB) (OR = 1.929, 95% CI: 1.116-3.332). Other postoperative complications, including edema, erythema, seroma, hematoma, and wound complications were not significantly different between the IORT and EBRT groups. EBRT was associated with higher rates post-radiation complications, including erythema (95.8% vs. 21.5%), skin dryness (30.8% vs. 12.4%), pruritus (26.6% vs. 17.4%), hyperpigmentation (48.3% vs. 9.9%), and telangiectasia (1.4% vs. 0.8%). Multivariate analysis showed that erythema, skin dryness and pruritus, and hyperpigmentation were more severe in the EBRT group, while breast induration was higher in the IORT group (OR = 4.109, 95% CI: 2.242-7.531). Excellent, good, and fair cosmetic outcome was seen in 11.2%, 72%, and 16.8% of the patients in the EBRT group and 29.8%, 63.6%, and 6.6% in the IORT group, respectively, suggesting that the cosmetic outcome was significantly better in the IORT group (P < .001). There wasn\'t statistically significant difference in recurrence-free survival and overall survival rates between two groups of patients who received either IORT or EBRT (P = .953, P = .56).
IORT is considered to have lower post-radiation complications and better cosmetic outcomes in breast cancer patients. Therefore, IORT might be used as the treatment of choice in eligible patients.
摘要：
背景：术中放疗（IORT）是早期乳腺癌（BC）的外束放疗（EBRT）的替代方案。在这里，我们比较了结果，IORT和EBRT的术后和放疗后并发症。
方法：我们进行了一项队列研究，以比较患者IORT和EBRT的并发症。IORT和EBRT并发症清单，用于评估和放疗后并发症和结局。
结果：总体而言，本研究分析了264名女性（IORT组121名，EBRT组143名），平均年龄（SD）为55±8.6岁。与EBRT组（四肢切除术+SLNB）相比，IORT组（四肢切除术+SLNB+IORT）术后疼痛更严重（OR=1.929，95％CI：1.116-3.332）。其他术后并发症，包括水肿,红斑,血清肿,血肿,伤口并发症在IORT组和EBRT组之间没有显着差异。EBRT与放射后并发症发生率较高相关，包括红斑（95.8%vs.21.5%），皮肤干燥（30.8%vs.12.4%），瘙痒（26.6%vs.17.4%），色素沉着过度（48.3%vs.9.9%），和毛细血管扩张(1.4%与0.8%）。多因素分析显示红斑,皮肤干燥和瘙痒，在EBRT组中色素沉着更严重，而IORT组乳房硬结较高(OR=4.109,95%CI:2.242-7.531)。很好,不错,11.2%的人看到了公平的美容结果，72%,EBRT组的患者占16.8%，占29.8%，63.6%,在IORT组中为6.6%，分别,提示IORT组的美容效果明显更好（P<.001）。两组接受IORT或EBRT的患者的无复发生存率和总生存率差异无统计学意义（P=.953，P=.56）。
结论：在乳腺癌患者中，IORT被认为具有较低的放疗后并发症和较好的美容效果。因此,IORT可作为符合条件的患者的首选治疗方法。
方法：我们进行了一项队列研究，以比较患者IORT和EBRT的并发症。IORT和EBRT并发症清单，用于评估和放疗后并发症和结局。
结果：总体而言，本研究分析了264名女性（IORT组121名，EBRT组143名），平均年龄（SD）为55±8.6岁。与EBRT组（四肢切除术+SLNB）相比，IORT组（四肢切除术+SLNB+IORT）术后疼痛更严重（OR=1.929，95％CI：1.116-3.332）。其他术后并发症，包括水肿,红斑,血清肿,血肿,伤口并发症在IORT组和EBRT组之间没有显着差异。EBRT与放射后并发症发生率较高相关，包括红斑（95.8%vs.21.5%），皮肤干燥（30.8%vs.12.4%），瘙痒（26.6%vs.17.4%），色素沉着过度（48.3%vs.9.9%），和毛细血管扩张(1.4%与0.8%）。多因素分析显示红斑,皮肤干燥和瘙痒，在EBRT组中色素沉着更严重，而IORT组乳房硬结较高(OR=4.109,95%CI:2.242-7.531)。很好,不错,11.2%的人看到了公平的美容结果，72%,EBRT组的患者占16.8%，占29.8%，63.6%,在IORT组中为6.6%，分别,提示IORT组的美容效果明显更好（P<.001）。两组接受IORT或EBRT的患者的无复发生存率和总生存率差异无统计学意义（P=.953，P=.56）。
结论：在乳腺癌患者中，IORT被认为具有较低的放疗后并发症和较好的美容效果。因此,IORT可作为符合条件的患者的首选治疗方法。
