Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):e139-44. doi: 10.1016/j.ijrobp.2012.03.015. Epub 2012 May 5.
To evaluate cosmetic outcome and its association with breast wound seroma after breast-conserving surgery (BCS) with targeted intraoperative radiation therapy (tIORT) boost for early breast cancer.
An analysis of a single-arm prospective study of 55 patients with early breast cancer treated with BCS and tIORT boost followed by conventional whole breast radiation therapy (WBRT) between August 2003 and January 2006 was performed. A seroma was defined as a fluid collection at the primary tumor resection site identified clinically or radiologically. Cosmetic assessments using the European Organization for Research and Treatment of Cancer rating system were performed at baseline before BCS and 30 months after WBRT was completed.
Twenty-eight patients (51%) developed a seroma, with 18 patients (33%) requiring at least 1 aspiration. Tumor location was significantly associated with seroma formation (P=.001). Ten of 11 patients with an upper inner quadrant tumor developed a seroma. Excellent or good overall cosmetic outcome at 30 months was observed in 34 patients (62%, 95% confidence interval 53%-80%). Seroma formation was not associated with the overall cosmetic result (P=.54).
BCS with tIORT boost followed by WBRT was associated with an acceptable cosmetic outcome. Seroma formation was not significantly associated with an adverse cosmetic outcome.
评估保乳手术后（BCS）联合术中靶向放疗（tIORT）加量在早期乳腺癌中的应用效果，分析其与乳房伤口血清肿之间的关系。
对 2003 年 8 月至 2006 年 1 月期间接受 BCS 和 tIORT 加量治疗后行常规全乳放疗（WBRT）的 55 例早期乳腺癌患者的单臂前瞻性研究进行分析。术中发现或影像学检查发现原发性肿瘤切除部位有液体聚集时定义为血清肿。使用欧洲癌症研究与治疗组织（EORTC）评分系统在 BCS 前和 WBRT 完成后 30 个月进行美容评估。
28 例患者（51%）发生血清肿，其中 18 例（33%）至少需要抽吸 1 次。肿瘤位置与血清肿形成显著相关（P=.001）。11 例内上象限肿瘤患者中有 10 例发生血清肿。30 个月时，34 例患者（62%，95%置信区间 53%-80%）的总体美容效果为优秀或良好。血清肿形成与整体美容效果无显著相关性（P=.54）。
BCS 联合 tIORT 加量后行 WBRT 与可接受的美容效果相关。血清肿形成与不良美容效果无显著相关性。
