Falco Michał, Masojć Bartłomiej, Rolla Magdalena, Czekała Agnieszka, Pietruszewska Jolanta, Rubik-Leszczyńska Agnieszka, Lewocki Mirosław, Łukowiak Magdalena, Kram Andrzej
Radiation Oncology Department, West Pomeranian Oncology Center, Strzałowska 22, 71-730 Szczecin, Poland.
Pathology Department, West Pomeranian Oncology Center, Strzałowska 22, 71-730 Szczecin, Poland.
Rep Pract Oncol Radiother. 2016 May-Jun;21(3):225-31. doi: 10.1016/j.rpor.2016.03.003. Epub 2016 Mar 29.
Novel techniques in oncology provide new treatment opportunities but also introduce different patterns of side effects. Intraoperative radiotherapy (IORT) allows a shortened overall treatment time for early breast cancer either combined with whole breast radiotherapy (WBRT), or alone. Although the early side effects of IORT are well known, data on clinically important late side effects, which require medical intervention, are scarce.
In this study, we analyze risk factors for seroma evacuation more than 6 months after IORT.
We evaluated 120 patients with a mean follow-up of 27.8 months (range: 7-52 months). Fifty-one patients received IORT only and 69 were additionally treated with WBRT.
Seroma evacuation was performed 6-38 months after IORT. Two (3.9%) events were observed in the IORT group and 14 (20%) in the IORT + WBRT group. Univariate (Kaplan-Meier) analysis showed that addition of WBRT to IORT increased the risk of seroma evacuation [hazard ratio = 5.5, 95% confidence interval: 2.0-14.7, P = 0.011]. In a multivariate analysis (Cox proportional hazards regression), WBRT and axillary lymph node dissection were significant risk factors for seroma evacuation (model P value = 0.0025).
WBRT applied after IORT is associated with increased risk of seroma evacuation, which might be considered as a late side effect.
肿瘤学中的新技术提供了新的治疗机会，但也带来了不同的副作用模式。术中放疗（IORT）可缩短早期乳腺癌的总体治疗时间，可与全乳放疗（WBRT）联合使用，也可单独使用。虽然IORT的早期副作用已为人所知，但关于需要医疗干预的具有临床重要性的晚期副作用的数据却很少。
在本研究中，我们分析了IORT后6个月以上血清肿引流的危险因素。
我们评估了120例患者，平均随访27.8个月（范围：7 - 52个月）。51例患者仅接受IORT，69例患者还接受了WBRT。
血清肿引流在IORT后6 - 38个月进行。IORT组观察到2例（3.9%），IORT + WBRT组观察到14例（20%）。单因素（Kaplan - Meier）分析显示，IORT联合WBRT增加了血清肿引流的风险[风险比 = 5.5，95%置信区间：2.0 - 14.7，P = 0.011]。在多因素分析（Cox比例风险回归）中，WBRT和腋窝淋巴结清扫是血清肿引流的显著危险因素（模型P值 = 0.0025）。
IORT后应用WBRT与血清肿引流风险增加相关，这可能被视为一种晚期副作用。
