Elliott, Elliott, Head Breast Cancer Research and Treatment Center, Baton Rouge, LA 70816, USA.
Surg Oncol. 2011 Jun;20(2):73-9. doi: 10.1016/j.suronc.2009.11.001. Epub 2009 Nov 28.
Failure after breast conserving surgery (BCS) and total breast irradiation usually occurs at the site of the original tumor. This has caused an increased interest in accelerated partial breast irradiation (APBI), because if radiation is delivered directly to the tumor bed there should be better local control. Patients greater than age 50 with core biopsy confirmed invasive ductal carcinoma were enrolled. They had preoperative ultrasound defining margins of less than 3.5 cm. Intraoperative ultrasound was also performed in an effort to ensure good surgical margins. After excision of the tumor, intraoperative radiotherapy (IORT) with the Intrabeam System was delivered to the tumor bed. The procedure has been performed on 67 patients. Sixty-one patients had it with the original surgery, while 6 had the procedure after re-exploration of the segmental mastectomy site. Because of the final pathology (surgical margins, tumor biology, and nodal status) 4 patients later had total mastectomy and 11 received total breast irradiation. When total breast irradiation is done the IORT serves as the radiation boost. The cosmetic results have been good to excellent, and there have been no serious surgical or radiation complications. To date there have been no local failures. IORT with the Intrabeam System is feasible, user friendly, versatile, with few complications, good cosmetic results, and great patient acceptance. It is practical and excellent for breast IORT in the community setting.
保乳手术后（BCS）和全乳放疗失败通常发生在原肿瘤部位。这导致了对加速部分乳腺放疗（APBI）的兴趣增加，因为如果将辐射直接施用于肿瘤床，应该会有更好的局部控制。入组患者为年龄大于 50 岁、经核心活检证实为浸润性导管癌的患者。她们术前超声检查显示肿瘤边缘小于 3.5 厘米。还进行了术中超声检查，以确保良好的手术边缘。切除肿瘤后，使用 Intrabeam 系统对肿瘤床进行术中放疗（IORT）。已经对 67 例患者进行了该手术。61 例患者在最初的手术中接受了该手术，6 例患者在局部乳房切除术部位再次探查后接受了该手术。由于最终的病理（手术边缘、肿瘤生物学和淋巴结状态），4 例患者后来接受了全乳切除术，11 例患者接受了全乳放疗。如果进行全乳放疗，IORT 可作为放疗增敏。美容效果良好至优秀，且无严重手术或放疗并发症。迄今为止，无局部复发。使用 Intrabeam 系统进行 IORT 是可行的、用户友好的、多功能的，并发症少，美容效果好，患者接受度高。它在社区环境中进行乳腺 IORT 是实用的，且效果极佳。
