术中放疗在早期乳腺癌保乳手术中的应用观察  

Intraoperative radiotherapy combined with breast conserving surgery in early breast cancer

作　　者：刘军[1] 黄林平[1] 周伟[2] 熊英[2] 戴甜甜[2] 韩媛媛[2] 

机构地区：[1]中日友好医院乳腺肿瘤中心,北京100029 [2]中日友好医院放射治疗科,北京100029

出　　处：《中日友好医院学报》2016年第3期137-140,F0004,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨术中放疗在早期乳腺癌保乳手术中的应用价值。方法：选择2013年10月~2015年2月符合入组条件的85例早期乳腺癌患者,术中放疗组22例行保乳手术及术中放疗;术后放疗组63例患者行保乳手术和术后放疗。2组患者的年龄、临床分期、肿瘤大小及病理分型、病理分化程度均无显著性差异（均P〉0.05）,观察术后手术区域并发症、放射性损伤、乳房美容效果及术后短期疗效。结果：2组患者均未出现局部复发及远处转移,生存率为100%。2组患者术后并发症及美容效果均无显著性差异（均P〉0.05）。术后并发症：术中放疗组2例患者需要抽吸3次以上的皮下积液、3例出现术后伤口红肿;术后放疗组5例需要抽吸3次以上的皮下积液;2例出现术后伤口红肿。结论：术中放疗在乳腺癌保乳手术中安全可行,有望在部分选择的早期乳腺癌患者中替代全乳照射。Objective：To evaluate the clinical value of intraoperative radiotherapy（IORT）combined with breast conserving surgery.Methods：Eighty-five patients with early stage breast cancer were enrolled from October2013 to February 2015.Twenty-two patients（IORT group） underwent intraoperative radiotherapy combined with breast conserving surgery.Sixty-three patients（control group） underwent postoperative radiotherapy combined with breast conserving surgery.Incidence of local complications,radiation injury,the cosmetic results and shortterm therapeutic efficacy were observed.Results：None of patients of the two groups had local recurrence or distant metastasis and survival rate was 100%.There was no significant difference in postoperative complications and cosmetic results between the two groups（all P 〉0.05）.In IORT group local complications included seroma needing more than three aspirations in 2 patients and evident redness and swelling of the skin in 3patients.In control group local complications included seroma needing more than three aspirations in 5 patients and evident redness and swelling of the skin in 2 patients.Conclusion：Intraoperative radiotherapy combined with breast conserving surgery was safe and reliable,and may be an alternative to whole breast irradiation in selected patients with early-stage breast cancer.

关 键 词：乳腺肿瘤 近距离放射疗法 术中放疗 

分 类 号：R737.9[医药卫生—肿瘤]