乳腺癌保留乳房手术联合术中放射治疗60例近期疗效观察  

Short-term effect of breast conserving surgery combined with intraoperative radiotherapy in 60 patients with breast cancer

作　　者：柴凡[1] 赵庆丽[1] 张锋军[1] 黄亚琼[1] 

机构地区：[1]解放军兰州军区兰州总医院乳腺外科,730050

出　　处：《中华乳腺病杂志（电子版）》2017年第1期13-18,共6页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：甘肃省自然科学基金资助项目(1606RJZA188)

摘　　要：目的总结乳腺癌保留乳房手术(简称保乳手术)联合INTRABEAM术中放射治疗的近期疗效、不良反应及美容效果。方法回顾性分析兰州军区兰州总医院乳腺外科2012年12月至2015年6月收治的60例行保乳手术联合INTRABEAM术中放射治疗乳腺癌患者的临床资料。所有患者术中经病理学确认切缘阴性后实施INTRABEAM术中放射治疗。分析患者术后DFS率、不良反应及美容效果。采用Kaplan-Meier法绘制DFS曲线。结果中位随访24个月(12~42个月),患者术后2年局部复发率为5%(3/60),术后2年DFS率为95%。本组患者中,8例(13.3%,8/60)出现放射治疗后乳腺纤维化,4例(6.7%,4/60)出现乳腺脂肪液化坏死,1例(1.7%,1/60)出现乳房血肿。患者术后美容效果总体满意率为90.0%(54/60),其中优秀率和良好率分别为53.3%(32/60)和36.7%(22/60)。结论乳腺癌保乳手术联合INTRABEAM术中放射治疗近期疗效和美容效果良好,不良反应少,值得临床推广。Objective To evaluate the short-term effect, adverse reaction and cosmetic result of breast conserving surgery combined with INTRABEAM intraoperative radiotherapy in breast cancer patients. Methods We retrospectively analyzed the clinical data of 60 patients who underwent breast conserving surgery combined with INTRABEAM intraoperative radiotherapy in Department of Breast Surgery, General Hospital of Lanzhou Military Command from December 2012 to June 2015. All patients received breast conserving surgery, then INTRABEAM intraoperative radiotherapy was given after postoperative pathology confirmed clear surgical margins. The DFS, adverse reaction and cosmetic result were analyzed. Kaplan-Meier method was used to draw DFS curve. Results The median follow-up was 24 months （12-42 months）. The local recurrence rate was 5% （3/60） two years after operation. The two-year DFS was 95%. There were 8 patients （13.3%, 8/60） with breast fibrosis after radiotherapy, 4 （6.7%, 4/60） with fat liquefaction and 1 （ 1.7%, 1/60） with breast hematoma. The satisfactory rate of patients in cosmetic effect was 90. 0% （54/60）, in which the excellent rate and the good rate were 53.3% （32/60） and 36.7% （22/60） respectively. Conclusion Breast conserving surgery combined with INTRABEAM intraoperative radiotherapy has beneficial short-term effect, favorable cosmetic result and a few adverse reactions, worthy of clinical practice.

关 键 词：乳腺肿瘤 乳房切除术 皮下 监测 手术中 放射疗法 计算机辅助 

分 类 号：R737.9[医药卫生—肿瘤]