术中电子线放疗在早期乳腺癌保乳手术瘤床加量放疗中的应用分析  

Intraoperative radiotherapy as a boost of tumor bed in breast-conserving surgery of early breast cancer

作　　者：王昕[1] 王翔[1] 王文彦[1] 高纪东[1] 宣立学[1] 李晔雄[2] 冯勤付[2] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院乳腺外科,北京100021 [2]中国医学科学院北京协和医学院肿瘤医院放射治疗科,北京100021

出　　处：《中国医刊》2013年第11期35-37,共3页Chinese Journal of Medicine

基　　金：首都临床特色应用研究课题(Z111107058811093)

摘　　要：目的探讨早期乳腺癌保乳手术后采用术中瘤床放疗替代术后瘤床加量外照射的安全性和可行性。方法 14例早期乳腺癌患者保乳手术后做术中瘤床区放疗,术后全乳外放疗。观察近期疗效、切口愈合情况、美容效果及不良反应。结果中位随访时间46.4个月,无局部复发、远处转移及死亡病例。切口感染1例,切口延迟拆线3例,中位愈合时间14天,无切口脂肪液化、水肿或血肿。美容效果优秀或良好12例。轻度皮肤色素沉着1例。无放疗相关急性血液学毒性。结论早期乳腺癌保乳术后,术中瘤床区补量放疗替代术后瘤床加量近期疗效稳定,美容效果好,不良反应及并发症少见。Objective To evaluate the safety and feasibility of intraoperative radiotherapy with post-operative whole breast radiotherapy instead of post-operative whole breast radiotherapy with a boost to the tumor bed in patients with early-stage breast cancer patients receiving breast-conserving surgery. Method 14 patients with early-stage breast cancer received breast-conserving surgery plus Mobetron 1000 mobile electron accelerator intra-operative radiothera- py and post-operative whole breast radiotherapy from July 2008 to Oct 2010. Postoperative recurrence and metastases were followed up as well as complications and cosmetic outcome. Result With a median follow-up time of 46.4 months, there are no local relapses, metastases and death cases. Among all the patients, average wound healing time is 14 days and 1 of them developed infection while 3 of them were delayed in wound healing. No patientsshowed wound edema and no lyponecrosis or hematomas were found. The evaluation of cosmetic outcome shows 12 patients were graded as excellent or good while 2 patients as fair or poor. No patients was found with radiotherapy related a- cute hematological toxicity and 1 patient was developed skin pigmentation. Conclusion The short-term follow-up re- vealed that intraoperative radiotherapy after breast-conserving surgery instead of whole breast radiotherapy in early breast cancer patients is safe and reliable with a better cosmetic outcome.

关 键 词：乳腺癌 保乳手术 术中电子线放疗 瘤床加量放疗 

分 类 号：R737.9[医药卫生—肿瘤]