Department of Radiotherapy and Radio-Oncology, Landeskrankenhaus, Paracelsus Medical University, Salzburg, Austria.
Int J Cancer. 2015 Mar 1;136(5):1193-201. doi: 10.1002/ijc.29064. Epub 2014 Jul 10.
To evaluate retrospectively rates of local (LCR) and locoregional tumor control (LRCR) in patients with locally advanced breast cancer (LABC) who were treated with preoperative chemotherapy (primary systemic treatment, PST) followed by breast-conserving surgery (BCS) and either intraoperative radiotherapy with electrons (IOERT) preceding whole-breast irradiation (WBI) (Group 1) or with WBI followed by an external tumor bed boost (electrons or photons) instead of IOERT (Group 2). From 2002 to 2007, 83 patients with clinical Stage II or III breast cancer were enrolled in Group 1 and 26 in Group 2. All patients received PST followed by BCS and axillary lymph node dissection. IOERT boosts were applied by single doses of 9 Gy (90% reference isodose) versus external boosts of 12 Gy (median dose range, 6-16) in 2 Gy/fraction (ICRU). WBI in both groups was performed up to total doses of 51-57 Gy (1.7-1.8 Gy/fraction). The respective median follow-up times for Groups 1 and 2 amount 59 months (range, 3-115) and 67.5 months (range, 13-120). Corresponding 6-year rates for LCR, LRCR, metastasis-free survival, disease-specific survival and overall survival were 98.5, 97.2, 84.7, 89.2 and 86.4% for Group 1 and 88.1, 88.1, 74, 92 and 92% for Group 2, respectively, without any statistical significances. IOERT as boost modality during BCS in LABC after PST shows a trend to be superior in terms of LCR and LRCR in comparison with conventional boosts.
回顾性评估接受新辅助化疗（全身系统治疗，PST）后行保乳手术（BCS）并接受术中电子放疗（IOERT）联合全乳照射（WBI）（1 组）或 WBI 后行电子或光子瘤床外扩野放疗（代替 IOERT）（2 组）的局部晚期乳腺癌（LABC）患者的局部（LCR）和局部区域肿瘤控制（LRCR）率。2002 年至 2007 年，83 例临床 II 期或 III 期乳腺癌患者入组 1 组，26 例患者入组 2 组。所有患者均接受 PST 后行 BCS 和腋窝淋巴结清扫。IOERT 推量采用 9 Gy（90%参考等剂量线）单次剂量，2 Gy/fraction（ICRU），外照射推量采用 12 Gy（中位剂量范围 6-16）。两组均行 WBI，总剂量 51-57 Gy（1.7-1.8 Gy/fraction）。1 组和 2 组的中位随访时间分别为 59 个月（范围 3-115）和 67.5 个月（范围 13-120）。相应的 6 年 LCR、LRCR、无转移生存率、疾病特异性生存率和总生存率分别为 1 组 98.5%、97.2%、84.7%、89.2%和 86.4%，2 组 88.1%、88.1%、74%、92%和 92%，差异无统计学意义。PST 后 LABC 行 BCS 时 IOERT 作为推量方式，与常规推量相比，在 LCR 和 LRCR 方面具有优势。
