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。
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.