针对乳腺癌的风险调整的手术内辐射疗法 (IORT):一项新的分析
Melvin J Silverstein1,2, Brian Kim3, Kevin Lin3
1Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA. melsilver9@gmail.com.
Annals of surgical oncology
|July 18, 2023
概括
风险适应的手术内放射治疗 (IORT) 对低风险的乳腺癌是安全的. 添加全乳房放射治疗 (WBRT) 显著降低了局部复发率,尽管这使理解IORT变得复杂.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 手术瘤学手术瘤学
背景情况:
- 随机试验证实,风险适应的术内放射治疗 (IORT) 是低风险乳腺癌全乳腺放射治疗 (WBRT) 的安全替代方案.
- 根据风险调整的策略包括额外的WBRT用于高风险的病理发现,从而影响复发率.
- 这种策略可能会高估IORT的独立有效性,因为它会通过WBRT减轻其影响.
研究的目的:
- 评估IORT的贡献,有或没有额外的全乳房治疗.
- 根据乳腺癌患者的治疗策略分析局部复发率.
主要方法:
- 分析了1600例乳腺癌,这些乳腺癌用风险调整IORT治疗,使用治疗意图和每条协议方法.
- 局部复发定义为任何 ipsilateral 乳腺瘤事件.
- 仅接受IORT与IORT与额外WBRT的患者之间的复发率的比较.
主要成果:
- 在平均63个月的随访期间,局部复发率根据治疗有显著差异.
- 仅接受IORT治疗的1393名患者的5年局部复发概率为5.95% (79次事件).
- 207名接受额外WBRT治疗高危病理的患者在5年内局部复发的概率为0.5% (2事件),p = 0.0009.9.
结论:
- 全乳腺治疗是IORT在风险适应性乳腺癌管理中的有效和必要的补充.
- 在风险调整协议中增加了WBRT的使用,这使得对IORT对地方控制的独立贡献的评估变得更加复杂.
- 进一步了解IORT的独立疗效需要仔细考虑并发WBRT使用.
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