Sacchini V, Beal K, Goldberg J, Montgomery L, Port E, McCormick B
Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, MRI-1026, New York, New York 10021, USA.
Br J Surg. 2008 Sep;95(9):1105-10. doi: 10.1002/bjs.6208.
Partial breast irradiation has been tested in limited pilot studies and shown to provide acceptable cosmesis, minimal toxicity and adequate local control. The aim of this study was to determine the feasibility of using quadrant high-dose intraoperative radiation therapy (IORT) for the treatment of early-stage breast cancer.
Fifty-two women with early-stage breast cancer were treated with breast-conserving therapy and IORT between October 2002 and January 2006. The first 18 women received a radiation dose of 20 Gy. The protocol was then amended and the remaining 34 women were treated with 18 Gy. Each patient was evaluated after surgery, and at 3, 6 and 12 months; complications, toxicity and cosmetic outcomes were recorded by the breast surgeon.
Women treated with 18 Gy appeared to have a more favourable cosmetic outcome compared with the earlier treatment group. At last follow-up, none of the women treated on the protocol had a breast recurrence.
Experience suggests that this IORT technique is feasible, although further follow-up is necessary to assess its therapeutic value.
局部乳腺照射已在有限的试点研究中进行了测试，结果显示其能提供可接受的美容效果、最小的毒性和足够的局部控制。本研究的目的是确定使用象限高剂量术中放射治疗（IORT）治疗早期乳腺癌的可行性。
2002年10月至2006年1月期间，52例早期乳腺癌女性接受了保乳治疗和IORT。前18例女性接受了20 Gy的放射剂量。随后方案进行了修订，其余34例女性接受了18 Gy的治疗。术后及术后3、6和12个月对每位患者进行评估；乳腺外科医生记录并发症、毒性和美容效果。
与早期治疗组相比，接受18 Gy治疗的女性似乎有更有利的美容效果。在最后一次随访时，按方案治疗的女性均未出现乳腺复发。
经验表明，这种IORT技术是可行的，尽管需要进一步随访以评估其治疗价值。
