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首页> 外文期刊>Journal of Cancer Therapy >Intraoperative Open-Cavity Implant for Accelerated Partial Breast Irradiation Using High-Dose Rate Multicatheter Brachytherapy in Japanese Breast Cancer Patients: A Single-Institution Registry Study
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Intraoperative Open-Cavity Implant for Accelerated Partial Breast Irradiation Using High-Dose Rate Multicatheter Brachytherapy in Japanese Breast Cancer Patients: A Single-Institution Registry Study

机译：使用高剂量率多导管近距离放射疗法在日本乳腺癌患者中进行术中开放腔植入术以加速部分乳房照射：单机构注册研究

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Background: Previous research has compared the efficacies of accelerated partial breast irradiation (APBI) and wholebreast irradiation (WBI). APBI immediately after surgery may provide more benefit after intraoperative insertion of catheters. Although balloon catheter-based APBI is available in the US, it is difficult in Japanese women, who have relatively small breasts. With the applicators being implanted during tumor removal, APBI can be started immediately after surgery. The aim of this study was to assess the safety and efficacy of APBI using the intraoperative open-cavity implant technique. Method: Patients (age≥40 years) with invasive breast cancer (diameter≤3 cm) were enrolled. Before lumpectomy, the insertion of applicators and delivery doses were simulated by computed tomography (CT). After confirmation of free margins and negative sentinel nodes (SNs) using frozen section analysis, applicators were inserted. Postoperative CT-based dose distribution analysis was performed using dose-volume histograms. APBI was started on the day of surgery, delivering 32 Gy in 8 fractions over the following 5-6 days, and it covered a distance of 2 cm from tumor margins. This observational study was approved by the institutional review board of our hospital. Results: From October 2008 to July 2012, 157 women (160 lesions) were enrolled (age 55.0 years, <40:9, SN+: 25, for patients’ request). The mean number of applicators used was 6.4 (2-15) and mean planning target volume was 35.8 cm3 (6.5-137.1 cm3). All radiotherapy-related toxicities were mild. However, 12 patients (7.5%) experienced wound breakdown because of surgical site infection. Two patients developed ipsilateral breast tumor recurrence (1 marginal, 1 at a distant site). Conclusions: Despite the small number of participants and a short follow-up period, our results suggest that this technique could be helpful in establishing clinical safety and efficacy.
机译：背景：先前的研究比较了加速局部乳房照射（APBI）和全乳照射（WBI）的疗效。手术后立即插入导管后，APBI可能会带来更多益处。尽管在美国可以使用基于球囊导管的APBI，但在乳房相对较小的日本女性中很难做到这一点。通过在切除肿瘤的过程中植入涂抹器，可以在手术后立即开始使用APBI。这项研究的目的是使用术中开放腔植入技术评估APBI的安全性和有效性。方法：纳入年龄≥40岁的浸润性乳腺癌（直径≤3cm）的患者。肿块切除术之前，通过计算机断层扫描（CT）模拟施加器的插入和输送剂量。在使用冰冻切片分析确认自由余量和阴性前哨淋巴结（SN）后，插入涂药器。术后使用剂量-体积直方图进行基于CT的剂量分布分析。 APBI在手术当天开始，在接下来的5-6天之内以8个分数分送32 Gy，并且距肿瘤边缘2 cm。这项观察性研究获得了我院机构审查委员会的批准。结果：2008年10月至2012年7月，招募了157名妇女（160个病灶）（年龄55.0岁，<40：9，SN +：25，应患者要求）。使用的平均施药器数量为6.4（2-15），平均计划目标体积为35.8 cm3（6.5-137.1 cm3）。所有与放疗相关的毒性均为轻度。但是，有12位患者（7.5％）由于手术部位感染而发生了伤口破裂。两名患者出现同侧乳腺肿瘤复发（边缘1例，远处1例）。结论：尽管参与者人数少且随访时间短，但我们的结果表明该技术可能有助于建立临床安全性和有效性。

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