Barros Alfredo Carlos S D, Hanna Samir A, Carvalho Heloísa A, Martella Eduardo, Andrade Felipe Eduardo M, Piato José Roberto M, Bevilacqua José Luiz B
Mastology Center, Hospital Sírio Libanês, Rua Dona Adma Jafet 91, 01308-050 São Paulo, SP, Brazil ; LIM 02, Discipline of Human Structural Topography, University of São Paulo Medical School, Avenida Dr. Arnaldo 455, 01246-903 São Paulo, SP, Brazil.
Department of Radiotherapy, Hospital Sírio Libanês, Rua Dona Adma Jafet 91, 01308-050 São Paulo, SP, Brazil.
Int J Breast Cancer. 2014;2014:568136. doi: 10.1155/2014/568136. Epub 2014 Dec 17.
Purpose. To assess feasibility, efficacy, toxicity, and cosmetic results of intraoperative radiotherapy (IORT) with electrons delivered by standard linear accelerators (Linacs) during breast conserving surgeries for early infiltrating breast cancer (BC) treatment. Materials and Methods. A total of 152 patients with invasive ductal carcinoma (T ≤ 3.0 cm) at low risk for local relapses were treated. All had unicentric lesions by imaging methods and negative sentinel node. After a wide local excision, 21 Gy were delivered on the parenchyma target volume with electron beams. Local recurrences (LR), survival, toxicity, and cosmetic outcomes were analyzed. Results. The median age was 58.3 years (range 40-85); median follow-up was 50.7 months (range 12-101.5). There were 5 cases with LR, 2 cases with distant metastases, and 2 cases with deaths related to BC. The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively. Complications were rare, and the cosmetic results were excellent or good in most of the patients. Conclusions. IORT with electrons delivered by standard Linacs is feasible, efficient, and well tolerated and seems to be beneficial for selected patients with early infiltrating BC.
目的。评估在早期浸润性乳腺癌（BC）保乳手术中，使用标准直线加速器（直线加速器）输送电子进行术中放射治疗（IORT）的可行性、疗效、毒性和美容效果。材料与方法。共治疗了152例局部复发风险低的浸润性导管癌（T≤3.0 cm）患者。所有患者经影像学检查均为单中心病变，前哨淋巴结阴性。在广泛局部切除术后，用电子束对实质靶区给予21 Gy照射。分析局部复发（LR）、生存率、毒性和美容效果。结果。中位年龄为58.3岁（范围40 - 85岁）；中位随访时间为50.7个月（范围12 - 101.5个月）。有5例发生LR，2例发生远处转移，2例死于BC。LR、远处转移和BC死亡的累积发生率分别为3.2%、1.5%和1.5%。并发症罕见，大多数患者的美容效果为优或良。结论。使用标准直线加速器输送电子进行IORT是可行、有效且耐受性良好的，似乎对选定的早期浸润性BC患者有益。
