Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Cancer Rep (Hoboken). 2024 Feb;7(2):e1950. doi: 10.1002/cnr2.1950. Epub 2024 Jan 11.
Intraoperative radiotherapy (IORT) is an alternative for external beam radiotherapy (EBRT) for early stage breast cancer (BC). Herein, we compared outcomes, postoperative and post-radiation complications of IORT and EBRT.
We conducted a cohort study to compare complications of IORT and EBRT in patients. A checklist of the complications of IORT and EBRT, was used to assess and post-radiation complications and outcomes.
Overall, 264 women (121 in IORT and 143 in EBRT group) with a mean (SD) age of 55 ± 8.6 years analyzed in this study. The IORT group (quadrantectomy + SLNB + IORT) had more severe post-operative pain compared to the EBRT group (quadrantectomy + SLNB) (OR = 1.929, 95% CI: 1.116-3.332). Other postoperative complications, including edema, erythema, seroma, hematoma, and wound complications were not significantly different between the IORT and EBRT groups. EBRT was associated with higher rates post-radiation complications, including erythema (95.8% vs. 21.5%), skin dryness (30.8% vs. 12.4%), pruritus (26.6% vs. 17.4%), hyperpigmentation (48.3% vs. 9.9%), and telangiectasia (1.4% vs. 0.8%). Multivariate analysis showed that erythema, skin dryness and pruritus, and hyperpigmentation were more severe in the EBRT group, while breast induration was higher in the IORT group (OR = 4.109, 95% CI: 2.242-7.531). Excellent, good, and fair cosmetic outcome was seen in 11.2%, 72%, and 16.8% of the patients in the EBRT group and 29.8%, 63.6%, and 6.6% in the IORT group, respectively, suggesting that the cosmetic outcome was significantly better in the IORT group (P < .001). There wasn't statistically significant difference in recurrence-free survival and overall survival rates between two groups of patients who received either IORT or EBRT (P = .953, P = .56).
IORT is considered to have lower post-radiation complications and better cosmetic outcomes in breast cancer patients. Therefore, IORT might be used as the treatment of choice in eligible patients.
术中放疗（IORT）是早期乳腺癌（BC）的一种替代外部束放疗（EBRT）的方法。在此，我们比较了 IORT 和 EBRT 的结果、术后和放疗后并发症。
我们进行了一项队列研究，以比较 IORT 和 EBRT 患者的并发症。使用 IORT 和 EBRT 的并发症检查表，评估和放疗后并发症和结果。
总体而言，本研究分析了 264 名女性（IORT 组 121 名，EBRT 组 143 名），平均年龄（SD）为 55±8.6 岁。与 EBRT 组（象限切除术+SLNB+IORT）相比，IORT 组（象限切除术+SLNB+IORT）术后疼痛更严重（OR=1.929，95%CI：1.116-3.332）。其他术后并发症，包括水肿、红斑、血清肿、血肿和伤口并发症，IORT 组和 EBRT 组之间无显著差异。EBRT 与更高的放疗后并发症发生率相关，包括红斑（95.8% vs. 21.5%）、皮肤干燥（30.8% vs. 12.4%）、瘙痒（26.6% vs. 17.4%）、色素沉着过度（48.3% vs. 9.9%）和毛细血管扩张（1.4% vs. 0.8%）。多变量分析显示，EBRT 组的红斑、皮肤干燥和瘙痒、色素沉着过度更严重，而 IORT 组的乳房硬结更严重（OR=4.109，95%CI：2.242-7.531）。EBRT 组 11.2%、72%和 16.8%的患者美容效果为优秀、良好和尚可，IORT 组分别为 29.8%、63.6%和 6.6%，表明 IORT 组的美容效果明显更好（P<.001）。接受 IORT 或 EBRT 的两组患者在无复发生存率和总生存率方面无统计学差异（P=.953，P=.56）。
IORT 被认为具有较低的放疗后并发症和更好的美容效果，因此，在符合条件的患者中，IORT 可能被用作治疗选择。
