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台湾地区关于使用Xoft Axxent® eBx®系统进行术中放疗(IORT)治疗早期乳腺癌的患者选择及肿瘤学安全性的多中心研究。

Multi-center study on patient selection for and the oncologic safety of intraoperative radiotherapy (IORT) with the Xoft Axxent® eBx® System for the management of early stage breast cancer in Taiwan.

作者信息

Lai Hung-Wen, Liu Liang-Chih, Ouyang Fu, Yao Chung-Chin, Jan Hsiang-Chun, Chang Ya-Herng, Tu Chi-Wen, Chen Dar-Ren, Cheng Tsui-Fen, Tzeng Yen-Dun, Hsu Huan-Ming, Yeh Ming-Hsin, Wu Yao-Chung, Yang Po-Sheng, Lam Hung-Bun, Hou Ming-Feng, Chen Fang-Ming

机构信息

Endoscopy & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan.

Comprehensive breast cancer center, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

PLoS One. 2017 Nov 2;12(11):e0185876. doi: 10.1371/journal.pone.0185876. eCollection 2017.

Abstract

BACKGROUND

In this multi-center study, we report the patient selection criteria for and preliminary oncologic outcomes associated with intraoperative radiotherapy (IORT) delivered by the Xoft Axxent® eBx® system for early-stage breast cancer in Taiwan.

METHODS

Patients with early breast cancer in Taiwan received breast conserving surgery and received IORT with Xoft Axxent® eBx® System during 2013-2015 was search from database of Taiwan IORT study cooperative group (T-IORTSCG). Patients' clinicopathologic characteristics and early post-operative results were collected and reported.

RESULTS

During the study period, 26 hospitals in Taiwan performed a total of 261 Xoft IORT procedures for breast cancer. The mean age of them was 52.9 ± 9.8 years (37-72), and tumor size was 1.5 ± 0.8 cm (0.1-4.2 cm) for invasive cancer and 1.2 ± 0.8 cm (range, 0.2-3.0 cm) for ductal carcinoma in situ (DCIS) lesions. Lymph node metastasis was found in 6 (2.3%) patients. The patients received IORT in Taiwan differed markedly from those used in the ELIOT and TARGIT-A studies. Specifically, patients selected for IORT in Taiwan tended to be younger, their tumors tended to be larger and the prevalence of lymph node metastasis tended to be lower. Among these 261 patients, 8 (3.1%) patients required whole breast radiotherapy. During a mean follow up of 15.6 months, locoregional recurrence was observed in 2 (0.8%) patients.

CONCLUSION

In real world experience, patients received IORT differed quite significantly with criteria formulated by trials. The preliminary results of IORT in Taiwan showed it is well acceptable by patients and clinicians.

摘要

背景

在这项多中心研究中,我们报告了台湾地区使用Xoft Axxent® eBx®系统进行术中放疗(IORT)治疗早期乳腺癌的患者选择标准及初步肿瘤学结果。

方法

从台湾术中放疗研究协作组(T-IORTSCG)数据库中检索2013年至2015年期间在台湾接受保乳手术并使用Xoft Axxent® eBx®系统进行IORT的早期乳腺癌患者。收集并报告患者的临床病理特征及术后早期结果。

结果

研究期间,台湾地区共有26家医院对261例乳腺癌患者进行了Xoft IORT治疗。患者的平均年龄为52.9±9.8岁(37 - 72岁),浸润性癌的肿瘤大小为1.5±0.8 cm(0.1 - 4.2 cm),导管原位癌(DCIS)病变的肿瘤大小为1.2±0.8 cm(范围0.2 - 3.0 cm)。6例(2.3%)患者发现有淋巴结转移。台湾接受IORT治疗的患者与ELIOT和TARGIT - A研究中的患者明显不同。具体而言,台湾选择接受IORT治疗的患者往往更年轻,肿瘤往往更大,淋巴结转移的发生率往往更低。在这261例患者中,8例(3.1%)患者需要进行全乳放疗。在平均15.6个月的随访期间,2例(0.8%)患者出现局部区域复发。

结论

在实际临床经验中,接受IORT治疗的患者与试验制定的标准有很大差异。台湾IORT的初步结果表明,患者和临床医生对其接受度良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/313b/5667880/dbad9034130a/pone.0185876.g001.jpg

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