摘要
目的探索INTRABEAM术中放疗系统在早期乳腺癌保留乳头乳晕复合体乳房切除联合乳房再造中应用的新方法，探讨该术中放疗新方法的安全性和可行性。方法收集2012年12月至2016年12月于本院治疗的20例早期女性乳腺癌患者的临床病例资料。分析术中放疗后乳头乳晕复合体、手术切口和乳房外形的情况以及急性放射损伤的发生情况。计算早期无复发生存率、无转移生存率和总生存率。结果20例患者均完成保留乳头乳晕复合体乳房切除和I期乳房再造术（假体植入），未见伤口感染、乳头乳晕坏死、植入物挛缩或者感染的病例。患者对术中放疗的耐受性良好。术后早期乳头乳晕复合体会出现不同程度的感觉缺失。1例出现纵隔淋巴结转移，确诊复发后14个月死亡。患者早期随访显示，乳房外形效果良好，无复发生存率、无转移生存率，总生存率均为95％。结论INTRABEAM术中放疗系统，应用低能x线术中照射乳头乳晕复合体临床安全性高，近期疗效尚可，美容效果好，不良反应小，并发症少，可以在早期乳腺癌保留乳头乳晕复合体乳房切除联合乳房再造手术中联合应用。
Objective To explore a novel application of INTRABEAM system in nipple sparing mastectomy combined with intraoperative radiotherapy for early stage breast cancer and investigate the efficacy and safety of this approach. Methods A total of 20 female patients with early stage breast cancer（from December 2012 to December 31, 2016） were retrospectively studied. NSM with or without axillary dissection was performed first. After confirming negative margin for NAC frozen section results and no poor local bleeding in the NAC, INTRABEAM IORT was carried out with a single dose of 16 Gy, followed by breast reconstruction. The complications and short-term outcomes were assessed. Results All 20 patients carried out I stage breast reconstruction. No acute radiation injury with symptoms （heart, lung, or hematologic system） or NAC necrosis was observed. No local recurrence or metastasis was observed except only one patient with mediastinum lymph node metastasis. Although every patient had reduction in NAC sensitivity, the contours of the breasts （including the NAC） were satisfactory. Conclusion INTRABEAM IORT may be a feasible and effective approach for NSM with stage I breast reconstruction in patients with early stage breast cancer.
出处
《国际医药卫生导报》
2017年第17期2665-2668,共4页
International Medicine and Health Guidance News
基金
国家自然科学基金青年项目（81402203）
关键词
乳腺癌
早期
保留乳头乳晕
术中放疗
Breast cancer
Early stage
Nipple sparing mastectomy
Intraoperative radiotherapy
