Gao Shi-Yu, Lin Ting-Chun, Liu Liang-Chih, Chen Wen-Ling, Liang Ji-An
Department of Radiation Oncology, China Medial University Hospital, No. 2, Yude Rd., North Dist., Taichung City, 404327, Taiwan.
Department of Breast Surgery, China Medial University Hospital, No. 2, Yude Rd., North Dist., Taichung City, 404327, Taiwan.
Breast Cancer Res. 2024 Dec 18;26(1):181. doi: 10.1186/s13058-024-01936-0.
Intraoperative radiotherapy (IORT) is a convenient treatment techniques for patients with early-stage breast cancer. We aimed to compare the outcome of IORT to that of whole-breast external beam radiotherapy (EBRT) in highly selected breast cancer patients based on the 2023 American Society for Radiation Oncology (ASTRO) Clinical Practice Guideline for Partial Breast Irradiation (PBI).
We reviewed patients who underwent breast-conserving surgery (BCS) and received either IORT or EBRT for early-stage breast cancer between 2014 and 2019. The outcomes of these patients were analyzed and compared across different risk stratifications according to the 2023 ASTRO Clinical Practice Guideline for PBI, which categorized the patients into "recommended", "conditionally recommended", or "conditionally not recommended" groups.
A total of 732 patients were enrolled with a mean follow-up time of 5.1 years. Among patients in the recommended group, the locoregional recurrence rates were 2.0% for IORT and 2.3% for EBRT (p = 0.978). Conversely, in the conditionally recommended or conditionally not recommended groups, IORT exhibited significantly higher locoregional recurrence rates compared to EBRT: in the conditionally recommended group, IORT had a recurrence rate of 11.1% versus 3.0% for EBRT (p = 0.044), and in the conditionally not recommended group, IORT had a rate of 13.8% versus 2.5% for EBRT (p = 0.010).
The locoregional recurrence rate in the IORT group was comparable to that of the EBRT group for patients recommended for PBI. However, for patients categorized as conditionally recommended or conditionally not recommended for PBI, the IORT group showed a higher locoregional recurrence rate, highlighting the need for careful patient selection.
术中放疗（IORT）是早期乳腺癌患者的一种便捷治疗技术。我们旨在根据2023年美国放射肿瘤学会（ASTRO）部分乳腺照射（PBI）临床实践指南，比较在经过严格筛选的乳腺癌患者中IORT与全乳外照射放疗（EBRT）的治疗效果。
我们回顾了2014年至2019年间接受保乳手术（BCS）并因早期乳腺癌接受IORT或EBRT的患者。根据2023年ASTRO PBI临床实践指南，将这些患者分为“推荐”、“有条件推荐”或“有条件不推荐”组，并对不同风险分层患者的治疗效果进行分析和比较。
共纳入732例患者，平均随访时间为5.1年。在推荐组患者中，IORT组的局部区域复发率为2.0%，EBRT组为2.3%（p = 0.978）。相反，在有条件推荐或有条件不推荐组中，IORT组的局部区域复发率显著高于EBRT组：在有条件推荐组中，IORT组的复发率为11.1%，而EBRT组为3.0%（p = 0.044）；在有条件不推荐组中，IORT组的复发率为13.8%，而EBRT组为2.5%（p = 0.010）。
对于推荐进行PBI的患者，IORT组的局部区域复发率与EBRT组相当。然而，对于被分类为有条件推荐或有条件不推荐进行PBI的患者，IORT组的局部区域复发率更高，这凸显了谨慎选择患者的必要性。
