Intraoperative radiation therapy delivered prior to lumpectomy for early-stage breast cancer:a single institution study
Objective: To evaluate the safety, cosmesis, and clinical outcome of intraoperative electron radiation therapy (IOERT) delivered prior to lumpectomy for early-stage breast cancer.Methods: From December 2008 to March 2012, 75 breast cancer patients (ages 34-66 years) were treated with IOERT during breast conservative surgery.IOERT was delivered using a mobile linear accelerator.Suitable energy and applicator size were chosen to ensure coverage of the tumor with anterior and posterior margins of 1 cm and lateral margins of 2 cm.Patients with sentinel node metastases or younger than 40 years received 8 Gy as boost followed by post-operative external beam radiation therapy of 50 Gy/25F;the others had 15 Gy, prescribed to the 90% isodose depth.Adjuvant treatment consisted of chemotherapy (55 patients), hormonal therapy (59 patients), or combined chemotherapy and hormonal therapy (41 patients).The safety, cosmesis, and short-term outcome were evaluated.Results: Median follow-up was 54 months (range: 30-66 months).Two (2.7%) patients developed post-surgical hematoma.Six (8.0%)patients developed mild breast fibrosis.Eight (10.7%) patients suffered from local pain.One (1.2%) patient experienced a post-operative infection.Sixteen (21.3%) patients developed Grade 1 pulmonary fibrosis.Forty-three (57.3%) patients had an excellent cosmetic result and 23 (30.7%) had a good cosmetic result.Three patients had an ipsilateral breast recurrence, with an actual 3-year local recurrence rate of 4.0%.One patient had an ipsilateral axillary recurrence, resulting in a 3-year regional recurrence rate of 1.3%.No distant metastases or deaths were observed.The 3-year disease free survival was 94.6%.Conclusions: Intraoperative electron radiation therapy delivered prior to lumpectomy is safe and feasible for selected patients with early-stage breast cancer.Early side effects,cosmesis and short-term efficacy are acceptable, but a longer follow-up is needed for evaluation of late side effects and long-term outcome.
Intraoperative radiotherapy intraoperative electron radiation therapy breast cancer IOERT whole breast radiation therapy
Wei Yu Zhi Lin Zhong-Jian Ju Xi-Ru Li Yan-Jun Zhang Qing-Long Kong Han-Shun Gong Jian-Dong Wang Lin Ma
Department of Radiotherapy,Chinese PLA General Hospital,Beijing 100853,China Department of Medical Oncology,Chinese PLA General Hospital,Beijing 100853,China Department of General Surgery,Chinese PLA General Hospital,Beijing 100853,China Department of Oncological Surgery,Chinese PLA General Hospital,Beijing 100853,China
国内会议
北京
英文
764-772
2016-01-09（万方平台首次上网日期，不代表论文的发表时间）