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早期浸润性乳腺癌与乳房术中局部电子线放射治疗:朱尔·博尔德研究所的经验

Early invasive cancer and partial intraoperative electron radiation therapy of the breast: experience of the jules bordet institute.

作者信息

Philippson C, Simon S, Vandekerkhove C, Hertens D, Veys I, Noterman D, De Neubourg F, Larsimont D, Bourgeois P, Van Houtte P, Nogaret J M

机构信息

Department of Radiation Oncology, Jules Bordet Institute, 1000 Brussels, Belgium.

Department of Radiophysics, Jules Bordet Institute, 1000 Brussels, Belgium.

出版信息

Int J Breast Cancer. 2014;2014:627352. doi: 10.1155/2014/627352. Epub 2014 Jun 9.

Abstract

Objectives. The aim of this prospective phase II study is to evaluate the treatment of early-stage breast cancer (T1 N0) with intraoperative electron radiation therapy (IOERT) in terms of local control, early complications, and cosmesis. Patients and Methods. From February 2010 to February 2012, 200 patients underwent partial IOERT of the breast. Inclusion criteria were unifocal invasive ductal carcinoma, age ≥40 years, histological tumour size ≤20 mm, and no lymph node involvement. A 21 Gy dose was prescribed over the 90% isodose line in the tumour bed. Median follow-up is 23.3 months (7-37). Results. Acute toxicity was not frequent (Grade 1: 4.5%, Grade 2: 1%). The cosmetic result was considered to be very good or good in 92.5%. One ipsi lateral out-quadrant recurrence at 18 months was observed. The crude and actuarial local recurrence rates after median follow-up were 0.5% and 0.9%, respectively. Conclusion. The preoperative diagnostic work-up must be comprehensive and the selection process must be rigorous for this therapeutic approach reserved for small ductal unifocal cancers. After a 23.3-month median follow-up time, the clinical results of IOERT for selected patients are encouraging for the locoregional recurrence and the toxicity rates. The satisfaction of our patients in terms of quality of life was extremely high.

摘要

目的。本前瞻性II期研究旨在评估术中电子线放射治疗(IOERT)对早期乳腺癌(T1 N0)的局部控制、早期并发症及美容效果。患者与方法。2010年2月至2012年2月,200例患者接受了乳房部分IOERT治疗。纳入标准为单灶浸润性导管癌、年龄≥40岁、组织学肿瘤大小≤20 mm且无淋巴结受累。在瘤床的90%等剂量线上给予21 Gy的剂量。中位随访时间为23.3个月(7 - 37个月)。结果。急性毒性反应不常见(1级:4.5%,2级:1%)。92.5%的患者美容效果被认为非常好或良好。观察到1例患者在18个月时出现同侧象限外复发。中位随访后的粗局部复发率和精算局部复发率分别为0.5%和0.9%。结论。对于这种仅适用于小导管单灶癌的治疗方法,术前诊断检查必须全面,选择过程必须严格。经过23.3个月的中位随访时间,IOERT对选定患者的局部区域复发和毒性率的临床结果令人鼓舞。我们的患者对生活质量的满意度极高。

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