Lemanski Claire, Bourgier Celine, Draghici Roxanna, Thezenas Simon, Morel Aurélie, Rouanet Philippe, Colombo Pierre-Emmanuel, Mourregot Anne, Delmond Laure, Fenoglietto Pascal, Ailleres Norbert, Azria David, Gutowski Marian
Fédération universitaire d'oncologie radiothérapie, ICM, Institut régional du cancer Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France.
Fédération universitaire d'oncologie radiothérapie, ICM, Institut régional du cancer Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France; IRCM, Institut de recherche en cancérologie de Montpellier, Inserm U1194, université Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France.
Cancer Radiother. 2020 Apr;24(2):114-119. doi: 10.1016/j.canrad.2020.01.007. Epub 2020 Mar 11.
To evaluate our long-term experience on one-day breast intraoperative radiotherapy (IORT) given as sole radiation treatment to selected patients with breast cancer.
Inclusion criteria of INTRAOBS study (prospective observational study) were: ER+ T1N0 unifocal ductal carcinoma; absence of lymphovascular invasion or of extensive intraductal component (Scarff-Bloom-Richardson grade III and HER2+++ excluded). Two different linacs were used (20Gy/1 fraction): one dedicated electron linac (<October 2011), and afterwards a mobile linac (50kV photons). The primary endpoint was the local recurrence rate (=ipsilateral breast cancer recurrences number). Secondary endpoints were recurrence-free survival (RFS), overall and specific survival, cosmetic results, and patient satisfaction.
Of the present pre-planned analysis for the first 200 patients (median age: 68 years; range, 59-87 years) who received IORT between January 2010 and October 2014 (median follow-up of 53.4 months). A total of 193 patients were still alive. The local recurrence rate was 2.5% (n=5). The 1- and 5-year local RFS rates were 100% and 95.2%, respectively. At 12 months post-surgery, satisfaction about IORT was excellent for 86.9% of patients. Cosmetic results were considered by patients and physicians as good or very good in 89.4% and 97.3% of cases, respectively.
IORT for selected patients with breast cancer shows low recurrence rates, good cosmetic outcomes and excellent satisfaction.
评估我们对选定乳腺癌患者进行单日乳腺术中放疗（IORT）作为唯一放疗手段的长期经验。
INTRAOBS研究（前瞻性观察研究）的纳入标准为：雌激素受体阳性（ER+）、T1N0单灶性导管癌；无淋巴管浸润或广泛导管内成分（排除斯卡夫-布卢姆-理查森三级和HER2++++）。使用了两种不同的直线加速器（20Gy/1次分割）：一台专用电子直线加速器（2011年10月前），之后是一台移动直线加速器（50kV光子）。主要终点是局部复发率（=同侧乳腺癌复发数）。次要终点是无复发生存期（RFS）、总生存期和特定生存期、美容效果及患者满意度。
对2010年1月至2014年10月期间接受IORT的前200例患者（中位年龄：68岁；范围59 - 87岁）进行本次预先计划的分析（中位随访53.4个月）。共有193例患者仍存活。局部复发率为2.5%（n = 5）。1年和5年局部无复发生存率分别为100%和95.2%。术后12个月时，86.9%的患者对IORT非常满意。患者和医生分别认为89.4%和97.3%的病例美容效果良好或非常好。
对选定的乳腺癌患者进行IORT显示出低复发率、良好的美容效果和极高的满意度。
