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在乳腺癌中,优化术内放射治疗作为瘤床增强,在乳腺癌中对整个乳房进行辐射
Jing Chen1,2, Xian Zhou1,2, Ke-Gui Weng1,2
1Department of Radiation Oncology Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing, 400030, China.
World journal of surgical oncology
|July 24, 2025
概括
术内放射治疗 (IORT) 与全乳房辐射 (WBI) 结合,对接受乳房保护手术 (BCS) 的乳腺癌患者显示出有前途. 最佳IORT剂量为10-20 Gy,避免使用更高剂量以防止伤口并发症.
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:
- 乳腺保护手术 (BCS) 是乳腺癌的常见治疗方法.
- 术内放射疗法 (IORT) 可以作为瘤床增强,与全乳房辐射 (WBI) 一起使用.
- 评估IORT与WBI结合的安全性,疗效和最佳剂量对于接受BCS的中国乳腺癌患者至关重要.
研究的目的:
- 在中国的乳腺癌患者中,评估术内放射治疗 (IORT) 结合全乳房照射 (WBI) 的安全性和有效性.
- 为了确定最佳的IORT剂量,以促进瘤床在乳腺保护手术 (BCS).
- 确定复发的风险因素,并评估伤口愈合结果.
主要方法:
- 对217名患有非转移性乳腺癌的女性患者进行了回顾性分析,接受了BCS.
- 患者在2020年5月至2023年12月期间接受了INTRABEAM IORT,随后接受了术后WBI.
- 评估的结果包括复发,无病生存期 (DFS),整体生存期 (OS),伤口愈合和放射性皮肤炎.
主要成果:
- 随访时间中位数为20个月;所有患者都存活了. 在2.3%的患者中观察到疾病复发.
- 复发的独立风险因素包括年龄<45岁和瘤大小>2厘米.
- 20 Gy IORT剂量与10 Gy (2.6%) 或>10至<20 Gy (0%) 相比,与延迟伤口愈合 (15.8%) 的增加有关,没有生存益处.
结论:
- IORT和WBI的组合证明了在中国接受BCS的乳腺癌患者的安全性和有效性.
- 年龄较小和瘤大小 (>2厘米) 与更高的复发风险有关.
- 建议IORT的最佳剂量范围为10-20 Gy,避免20 Gy由于增加的伤口并发症而没有生存优势.
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