Department of Radiology, Scott and White Healthcare, Texas A&M College of Medicine, Temple, TX, USA.
Breast J. 2011 Mar-Apr;17(2):187-90. doi: 10.1111/j.1524-4741.2010.01041.x. Epub 2011 Feb 10.
Our purpose was to evaluate and compare the imaging sequela and complications of accelerated partial breast irradiation (APBI) with those occurring in patients treated with standard external beam therapy. Patient selection included those who met the criteria for possible ABPI: age 45 or older; cancer stage T1N0M0 or ductal carcinoma in situ 3 cm or less, and negative surgical margins. One hundred and ninety seven had complete records and films available for review. Ninety-seven (49%) were treated with APBI (MammoSite) and 100(51%) were treated with external beam. Image findings for APBI versus external beam were: distortion 90(93%) versus 83(83%), seroma 67(69%) versus 7(7%), skin edema 52(54%) versus 47(47%), increased stroma 75(77%) versus 66(66%), calcifications 10(10%) versus 6(6%), and fat necrosis 12(12%) versus 6(6%). For APBI, skin and stromal edema was more commonly focal. At imaging, the seroma rate was statistically and significantly different between the two treatment modes (p < 0.0001). For patients treated with APBI, seroma formation was not related to balloon size and only weakly related to lumpectomy cavity size. The complication rate was significantly higher for those treated with APBI (36 versus 20%) and the types and treatment of complications differed. There were three recurrences among the APBI group and none among those treated with external beam radiation.
我们的目的是评估和比较加速部分乳房照射（APBI）与标准外部束治疗的患者发生的影像学后遗症和并发症。患者选择包括符合可能接受 APBI 的标准的患者：年龄 45 岁或以上；癌症分期 T1N0M0 或导管原位癌 3 厘米或更小，且切缘阴性。197 例患者有完整的记录和可用于审查的胶片。97 例（49%）接受 APBI（MammoSite）治疗，100 例（51%）接受外部束治疗。APBI 与外部束治疗的影像学表现为：变形 90 例（93%）与 83 例（83%），血清肿 67 例（69%）与 7 例（7%），皮肤水肿 52 例（54%）与 47 例（47%），间质增加 75 例（77%）与 66 例（66%），钙化 10 例（10%）与 6 例（6%），脂肪坏死 12 例（12%）与 6 例（6%）。对于 APBI，皮肤和间质水肿更常见为局灶性。在影像学上，两种治疗方式之间的血清肿发生率有统计学意义上的显著差异（p < 0.0001）。对于接受 APBI 治疗的患者，血清肿的形成与球囊大小无关，仅与乳房切除术腔大小弱相关。接受 APBI 治疗的患者并发症发生率明显更高（36%比 20%），并发症的类型和治疗方法也不同。APBI 组有 3 例复发，而接受外部束放射治疗的患者无一例复发。
