Clinical Research Papers:
Clinical analysis of intraoperative radiotherapy during breast-conserving surgery of early breast cancer in the Chinese Han population
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Xin Wang1, Jiaqi Liu1,*, Wenyan Wang1,*, Qinfu Feng2,#, Xiang Wang1,#
1Department of Breast Surgical Oncology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China
2Department of Radiotherapy, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China
*These authors have contributed equally to this work
Xiang Wang, e-mail: [email protected]
Keywords: breast cancer, breast-conserving surgery, intraoperative radiotherapy
Received: August 11, 2015 Accepted: September 16, 2015 Published: October 17, 2015
Purpose: While results of intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS) have been reported when used either as a boost at the time of surgery or as the sole radiation treatment, the clinical safety and cosmetic outcome of IORT in the Chinese Han population has not. This report reviews oncologic and cosmetic outcomes for Chinese Han breast cancer patients who received IORT either as a boost or as their sole radiation treatment at our hospital.
Method: From July 2008 to December 2012, 50 early-stage Chinese Han breast cancer patients received BCS and IORT, either as boost or as their sole radiation treatment. Patients received adjuvant chemotherapy or hormonal therapy, according to our institution’s guidelines. Patients were followed to determine oncologic events, short-term toxicity and overall cosmesis.
Results: With a median follow-up of 51.8 months (range 22.6 months to 75.7 months), 2 patients (4.0%) developed local relapses and were salvaged by mastectomy. There were no metastases and no deaths. The average wound healing time was 17 days. Three patients (6.0%) developed postoperative infection, 5 patients (10.0%) had delayed wound healing, and 2 patients (4.0%) experienced wound edema. There were no lyponecrosis or hematomas observed. The evaluation of cosmetic outcome showed 44 patients (88.0%) graded as excellent or good while 6 patients (12.0%) were graded as fair or poor. No patients experienced radiotherapy related acute hematological toxicity, but 3 patients (6.0%), all IORT boost patients, developed skin pigmentation.
Conclusion: For early-stage breast cancer patients, intraoperative radiotherapy after breast-conserving surgery in the Chinese Han population is both safe and reliable and has resulted in very acceptable cosmetic outcomes.
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