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Objective:To compare and analyze the efficacy and safety of intraoperative radiotherapy (IORT) combined with conventional therapy (surgery combined with radiochemotherapy) and conventional therapy alone for pancreatic cancer.Methods:Literature review was conducted from PubMed, Cochrane Library, Web of Science, Embase, Chongqing VIP, CNKI, Wanfang Data and China Biomedical Literature Service System (SinoMed). The literatures that met the inclusion criteria were screened and the data were extracted. Meta-analysis was carried out by RevMan 5.4 software.Results:A total of 11 studies consisting of 813 patients were included. According to the combined results, compared with conventional therapy, IORT combined with conventional therapy could improve the overall survival rate of pancreatic cancer ( HR=0.66, 95% CI=0.54-0.81, Z=4.03, P<0.001), and did not increase the treatment-related side effects ( OR=1.00, 95% CI=0.69-1.46, Z=0.01, P=0.99), but failed to bring benefit to the local control rate ( HR=0.56, 95% CI=0.31-1.01, Z=1.93, P=0.05). Conclusions:The overall survival rate in the IORT combined with conventional therapy group is significantly better than that in the conventional therapy group. No significant difference is found in the treatment-related adverse reactions between two groups. IORT combined with conventional therapy is worthy of clinical application.
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Objective To explore the clinical efficacy of surgical operation combined with INTRABEAM intraoperative radiotherapy in the limb-sparing treatment of soft tissue sarcoma. Methods A retrospective study was performed on four patients with limb soft tissue sarcoma admitted from July 2020 to October 2021 who received limb sparing surgery combined with INTRABEAM intraoperative radiotherapy. The operation went smoothly without anesthesia or accident. Results All the four patients received follow-up, ranging from 6 to 22 months. One patient had local recurrence two months after the surgery, and the patient refused amputation and received chemotherapy and targeted therapy. One patient had pulmonary metastasis ten months after the surgery and underwent surgical resection. One recurrent patient had poor limb function, and the other three patients had normal limb function. Conclusion Surgical operation combined with INTRABEAM intraoperative radiotherapy can preserve limb function while improving local control and quality of life.
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The adjacency or invasion to great vessels such as superior mesenteric artery/vein and celiac axis increase the difficulties to achieve R 0 resection and evoked high local recurrence for patients with borderline resectable pancreatic cancer. Intraoperative radiation therapy refers to a single high-dose irradiation during the surgery, which achieved the purpose of precise target treatment and protected normal tissues. In borderline resectable pancreatic cancer, preoperative radiotherapy and chemotherapy combined with surgery and intraoperative radiotherapy has a better effect, and compared with surgery alone, the addition of intraoperative radiotherapy does not increase the risk of serious postoperative complications. Here, we summarized the application of intraoperative radiation therapy in borderline resectable pancreatic carcinoma.
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Objective:To assess the shielding requirements of low energy X-ray intraoperative radiotherapy room under the domestic and foreign standards and guidelines, to measure the sured transmission factors for a range of shielding materials, the ambient dose equivalent rate around concerned positions and the shielding effect of protective devices, so as to provide references for shielding design of such radiotherapy units and applications of radiological protection devices.Methods:The required shielding thicknesses for a treatment room with INTRABEAM intraoperative radiotherapy system were calculated under the Chinese national standard GBZ 121, IPEM report No. 75 and NCRP report No. 151, respectively. The transmission factors for a range of shielding materials including solid water slab, shielding sheet and shielding apron were measured. Moreover, the ambient dose equivalent rates were measured under the simulated working conditions and the shielding effectiveness of a lead screen was evaluated.Results:The required lead thicknesses calculated under different standards and guidelines were less than 0.6 mm for all the concerned points, with the differences at sub-millimeter level. The low energy X-rays generated by this equipment attenuated rapidly in the shielding materials. The measured transmission factors of 0.05 mm lead equivalent shielding sheet and 0.25 mm lead equivalent shielding apron were 0.068 and 0.003 8, respectively. When the radiation was delivered using spherical applicator without any attenuation, the ambient dose equivalent rates at 1 m and 2 m from the X-ray source were 10.7 and 2.6 mSv/h, respectively. The corresponding measurement values decreased to 3.8 and 0.9 μSv/h, respectively, when the spherical applicator was inserted into a small water tank. Meanwhile, the ambient dose equivalent rate at 2 m was reduced to the background level when using protective screen.Conclusions:The shielding requirements for a low energy X-ray intraoperative radiotherapy facility are minimal, with low effective energy of X-rays generated by this equipment, but the dose rate close to the unshielded radiation source is high. The shielding scheme of treatment room should be optimized in design and the protective device should be used in a reasonable way.
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Objective:To compare the survival and prognostic factors of intraoperative radiotherapy (IORT) and postoperative radiotherapy (PORT) in female patients, aged≥50 years, diagnosed with node-negative breast cancer (≤ 3 cm in size).Methods:Clinical data of eligible early breast cancer patients between 2010 and 2015 were obtained from the SEER database. Patients were divided into the IORT and PORT groups according to the radiotherapy record and propensity score matching (PSM) was subsequently conducted. Kaplan-Meier curve was used to evaluate the overall survival (OS) and breast cancer-specific survival (BCSS) between two groups and Cox proportional hazard regression analysis was used to explore the risk factors of clinical prognosis.Results:7 068 patients were included after PSM. The median follow-up time was 32.0 months. The 5-year OS rates in the IORT and PORT groups were 96.8% and 93.8%, respectively. Univariate Cox analysis showed that radiotherapy, age, histological grade, T stage, estrogen receptor (ER) status and progesterone receptor (PR) status were the independent risk factors for OS, and histological grade, T stage, ER status, PR status and chemotherapy were the independent risk factors for BCSS. Multivariate Cox regression analysis demonstrated that patients who received IORT had better OS than PORT counterparts ( P=0.020). Besides, patients aged≥60 years obtained worse OS than those aged<60 years ( P=0.003). Patients with T 2 stage or ER-negative tumors had worse OS than those with T 1 stage tumors ( P<0.001) or ER-positive tumors ( P=0.001). Patients with grade Ⅲ-Ⅳ tumors achieved worse BCSS ( P=0.004). Subgroup analysis showed that IORT yielded better OS for elderly patients (≥60 years), grade Ⅲ-Ⅳ tumors, infiltrating duct carcinoma, T 2 stage tumors, ER-positive tumors, PR-positive tumors and patients without chemotherapy. Conclusions:IORT may bring benefit for highly selected patients with low risk of recurrence, which is not inferior to PORT in terms of short-term survival. Prospective studies with longer follow-up time are needed to confirm the findings.
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Objective:To design a drum-shaped applicator through Monte Carlo simulation for breast intraoperative radiotherapy.Methods:Applicator designing process is as follows: first, determined the shape of the applicator based on the geometric characteristics of the breast tumor bed closed to the chest wall; second, calculated the scattering angle and dose rate of the electron beam after passing through a series of scattering foils of different thicknesses to determine the thickness of the scattering foil; thrid, modeled the layer according to the applicator′s geometric characteristics where modulator located, and designed the modulator through the relationship between the geometric characteristics of the layer and the surface dose of the applicator. EGSnrc/BEAMnrc and EGS4/DOSXYZ were employed to model the head of the Mobetron, the layer, the applicator, and to calculate the dose distributions.Results:The applicator has two components. The upper component is a 3cm-diametre cylindrical collimator with 0.5cm wall made of 0.3cm steel and 0.2cm water equivalent material (WEM), a 0.13cm-foil made of tansgen. The lower component is a 4cm-diametre drum made of 0.2cm WEM and a 0.14cm maximum thickness hill-shaped modulator made of steel. When the energy of electron beam was 12MeV, the dose rate was about 90.44 cGy/min, and the depth of the 50% isodose curve was 1cm.Conclusion:The applicator is successfully designed, and can obtain a drum-shaped dose distribution.
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Objetivo: Este estudo objetivou avaliar o custo-efetividade da aplicação da radioterapia intraoperatória com elétrons (RIOe) no paciente com câncer retal localmente avançado (CRLA) submetido a radio/quimioterapia neoadjuvante seguida de ressecção incompleta (margem comprometida ou doença grosseira residual). Métodos: Para tanto, foi elaborado um modelo de Markov. Os dados de eficácia, efeitos secundários, controle local e sobrevida global foram extraídos da literatura. A perspectiva considerada foi a do sistema de saúde privado brasileiro. Considerou-se, para o custo e para a efetividade, uma taxa de desconto anual de 5%. Resultados: A estratégia que continha a RIOe mostrou-se, nesse cenário, dominante em comparação à estratégia que não envolvia essa abordagem. Os resultados mostraram-se robustos após análises de sensibilidade uni e multivariadas. Conclusão: Concluiu-se que pode ser vantajosa, tanto para os pacientes com CRLA quanto para as operadoras de saúde do mercado privado brasileiro, a aplicação de RIOe na ocorrência de cirurgia subótima, ainda que se sugira que esses dados devem ser confirmados posteriormente, por meio da coleta de dados de mundo real, devido à ausência de níveis robustos de evidência, na literatura, para esse cenário clínico específico.
Objective: This study aimed to evaluate the cost-effectiveness of intraoperative electron radiotherapy (IOeRT) in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant radio-chemotherapy, followed by incomplete resection (compromised margin or gross residual disease). Methods: A Markov model was constructed. Data on efficacy, side effects, local control and overall survival were extracted from the literature. The perspective was that of the Brazilian private health system. For the cost and effectiveness, an annual discount rate of 5% was considered. Results: The strategy that contained IOeRT was, in this scenario, dominant, in comparison to standard of care. Results were considered robust, after univariate and multivariate sensitivity analyzes. Conclusions: We concluded that it can be advantageous, both for patients with LARC submitted to suboptimal surgery, as well as for Brazilian health insurance companies, the application of IOeRT. Although it is suggested that these results should be confirmed later, through the collection of real-world data, due to the absence of randomized controlled trials, in this specific clinical scenario.
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Radiotherapy , Colorectal Neoplasms , Markov Chains , Cost-Benefit Analysis , Supplemental HealthABSTRACT
Purpose: We aimed to report the experience of intraoperative electron radiation therapy (IOERT) with Mobetron (Intraop Medical Incorporated, Santa Clara, CA, USA) as a partial breast irradiation (PBI) for patients with early-stage breast cancer and explanation of IOERT application and present early clinical and cosmetic result. Materials and Methods: Between November 2012 and February 2014, in Ankara Oncology Hospital, Radiation Oncology Clinic, was performed IOERT as a PBI with a single dose of 21 Gy for 21selected patients. Median tumor size was 1.5 cm (range, 0.6–2.8 cm). Median treatment duration was 2.04 min (range, 1.26–2.44 min). According to final pathology, two patients were found to have close margin and mastectomy was applied. Three cases (two were N1 mic and one case had perineural invasion and tumor size was >2 cm) received whole breast irradiation. Results: Median follow-up time was 3 years (range, 26–42 months). One patient died because of nonbreast cancer reason, all of the other patients (except one) alive without disease. There was no Grade 3 or 4 toxicities related to the IOERT. Good or excellent cosmesis was revealed 79% (15/19) and 95% (18/19), by physician and patient, respectively. Conclusion: IOERT, for patients with early-stage breast cancer as a part of breast-conserving treatment, offer patients better cosmetic results with less skin toxicity and increases comfort of patients by shortening duration of treatment time
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Objetivos: Comparar os resultados de controle local e sobrevida global e fazer uma análise econômica comparativa da radioterapia intraoperatória com elétrons (IOeRT) para o tratamento da neoplasia de mama inicial, em comparação à radioterapia conformacional de toda a mama (RT 3D). Métodos: Foi feita revisão sistemática da literatura e, posteriormente, considerando-se os resultados comparáveis de eficácia, análise de minimização de custos, comparando as técnicas mencionadas anteriormente. Resultados: Foi incluído um estudo randomizado. Observou-se pequeno aumento do número de falhas locais em cinco anos (4,4 vs. 0,4%), sem alteração, porém, na sobrevida global. Quando se restringiu o estudo às mulheres com tumores de até 2,0 cm de diâmetro, grau I ou II, com axila negativa ou com até três linfonodos comprometidos e com tumores não classificados como triplos-negativos, chegou-se a um nível comparável de controle local (1,5% de recidivas em cinco anos), sem diferenças significativas no tocante aos efeitos secundários ao tratamento. Em análise econômica posterior, optou-se, então, pelo estudo de minimização de custos, sob a perspectiva das operadoras de saúde do sistema de saúde privado brasileiro, tendo como base os custos dos procedimentos descritos na Classificação Brasileira Hierarquizada de Procedimentos Médicos (CBHPM), 5ª edição. Nesta análise, observou-se que a aplicação da IOeRT implica uma economia de recursos da ordem de 51,5% por tratamento. Conclusão: Conclui-se que a IOeRT é opção que leva à economia de recursos quando utilizada no tratamento de mulheres com câncer de mama inicial, sob a perspectiva das operadoras de saúde do Brasil, quando observados os critérios de inclusão descritos previamente.
Objectives: To compare local control and overall survival and perform an economic analysis between intraoperative electron beam radiation therapy (IOeRT) and conformal radiotherapy, directed to the whole breast (RT 3D), for the treatment of early breast cancer. Methods: A systematic review of the literature was performed, with the inclusion of 1 controlled randomized study, comparing IOeRT with standard treatment RT 3D, in early breast cancer. Posteriorly, due to comparable results between the studied techniques, a cost-minimization analysis was executed. Results: There was a small increase in the number of local failures, in 5 years (4.4 vs. 0.4%), but with no changes in overall survival. When the analysis was restricted to women with tumors up to 2.0 cm, grades I or II, with negative axilla or with up to 3 compromised lymph nodes and with tumors not classified as triple-negative, a comparable level of local control was reached (1.5% over 5 years), without significant differences in treatment side effects. In the following economic analysis, a cost minimization study was chosen, once both treatments were equivalent, considering local control and overall survival. The perspective was that of the Brazilian private healthcare system, based on the costs of the procedures according to the Brazilian Hierarchical Classification of Medical Procedures (CBHPM), 5th edition. In this analysis, it was observed that the delivery of IOeRT implies a resource saving of 51.5% per treatment. Conclusion: We conclude that IOeRT is a very interesting option, that leads to resource savings, when used in the treatment of women with early breast cancer, observing the inclusion criteria previously described, in the Brazilian health care payer's perspective.
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Humans , Radiotherapy , Breast Neoplasms , Efficacy , Costs and Cost AnalysisABSTRACT
Although surgery,radiotherapy and chemotherapy have made great progress,pancreatic cancer is still the most fatal malignant tumor,with a 5-year overall survival rate of only about 4% . Many studies have demonstrated that the local recurrence of pancreatic cancer is an important cause of high mortality,and the failure rate after local excision is still as high as 50~80% . There-fore,how to improve the local control rate of pancreatic cancer has been a hot spot of concern. Due to the adjacent organs and tissues (such as bone marrow,spinal cord,kidney,liver,intestine,etc. ),the dose of external irradiation(EBRT) is limited. Increasing local control rates and reducing treatment side effects are trends in future treatments. Intraoperative radiotherapy has the advantages of do-simetry and direct vision treatment to be increasingly used in the treatment of pancreatic cancer,becoming an important part of com-prehensive treatment. This article summarizes the clinical research results of intraoperative radiotherapy for pancreatic cancer in recent years,in order to provide the reference for clinicians.
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Intraoperative radiotherapy (IORT) is a radiotherapy method that uses a radiotherapy device to provide a brachytherapy with single high-dose radiation to a target tissue (primary tumor beds,residual tumors,and lymphatic drainage areas) during surgery,which includes intraoperative electron beam radiotherapy and high-dose-rate intraluminal brachytherapy.Nowadays,the implementation of precise radiation dose is an important part of multidisciplinary,individualized treatment of tumors.IORT achieves precise treatment by maximizing the radiation dose to the target volume and protecting surrounding normal tissues as much as possible.This article describes the recent research on IORT.
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Currendy,the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger.Due to the local changes of the tumor residual cavity after the breast conserving surgery,we can't accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount,and the course of treatment is longer.Intra-operative radiation therapy(IORT) can avoid the impact of respiratory motion and postural changes.Meanwhile,it can immediately irradiate the tumor bed during operation accurately.For patients,IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin and subcutaneous tissue.So IORT is convenient,easy to be accepted,and has relatively few complications,good cosmetic results and so on.In recent years,more and more Cancer Center choose breast conserving surgery combined with IORT for treatment of early stage breast cancer and make relative researches in terms of the indications,methods,dosage,efficacy and prognosis of IORT.
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PURPOSE: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. MATERIALS AND METHODS: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. RESULTS: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. CONCLUSIONS: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.
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Female , Humans , Breast Neoplasms , Breast , Cicatrix , Follow-Up Studies , Incidence , Luminescence , Mastectomy, Segmental , Radiotherapy , Seroma , SkinABSTRACT
Objective To investigate the short?term complications and cosmetic outcomes of radiotherapy in breast conserving surgery for early?stage breast cancer. Methods A retrospective analysis was performed on clinical data from 30 patients with early?stage breast cancer from 2013 to 2015. All patients underwent breast conserving surgery combined with intraoperative low?energy X?ray radiotherapy. The prescribed dose was 20 Gy at the surface of the applicator. Local complications, radiation injury, and cosmetic outcomes were observed after surgery. Results No grade 3?4 adverse reactions were found in patients. In terms of short?term complications, four patients (13%) had seroma, two of whom needed suction treatment;three patients ( 10%) had grade 1?2 skin erythema. Half of the patients had excellent cosmetic outcomes. None of the patients had local recurrence or distant metastasis. Conclusions Intraoperative low?energy X?ray radiotherapy is safe and feasible in breast conserving surgery for breast cancer. It can be considered as an optional approach for tumor bed boost in some patients with early?stage low?risk breast cancer.
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Objective To explore the clinical efficacy and safety of intraoperative radiotherapy (IORT) for the patients with unresectable locally advanced pancreatic cancer. Methods Cochrane library, PubMed, EMbase, CBM, CNKI, VIP database and WANFANG database were used to retrieve, in addition to manual retrieval important literature references and conference papers. The randomised controlled trials, cohort study, controlled clinical trials of the IORT in unresectable locally advanced pancreatic cancer were searched. According to the inclusion criteria and exclusion criteria, after the extraction of literature and data, RevMan 5.3 software was used for meta-analysis. Results The total of 1 401 articles were retrieved, 7 met the inclusion criteria, including 1 for randomized controlled trials, 4 for cohort study, 2 for case-control study. 313 cases in the IORT group, 362 cases in the control group, and meta-analysis showed that IORT group was better than control group in overall survival (OS) (Z=4.15, P<0.000 1, RR=2, 95%CI 1.05-2.94). Because lack of complete data in local control rate, pain remission rate, complications, descriptive analysis was done, rather than meta-analysis. Conclusions IORT may improve the OS of patients with unresectable locally advanced pancreatic cancer and the local control rate, and effectively alleviate pain with favorale safety but it still needs high quality randomized controlled trials to confirm.
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Objective To assess the prognostic benefits of intraoperative radiotherapy (IORT) with electron beam among patients with unresectable locally advanced pancreatic cancer.Methods Between January 2009 and December 2014,167 patients with unresectable locally advanced pancreatic cancer received IORT with electron beam (10-20 Gy) in our hospital.After surgery,12 patients were treated with external beam radiotherapy,56 patients with chemoradiotherapy (CRT),and 17 patients with chemotherapy.Overall survival (OS),local recurrence,and toxicities were retrospectively analyzed.The Kaplan-Meier method was used to calculate survival rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100％.The median OS time was 10.3 months,and the 2-year OS rate was 22％.The median progression-fiee survival (PFS) time was 6.3 months,and the 2-year PFS rate was 9.9％.The cancer-specific survival (CSS) time was 11.2 months,and the 2-year CSS rate was 23.6％.In the patients treated with IORT alone at doses of＜15 Gy,15 Gy and＞15 Gy,the median OS times were 6.2 months vs.9.1 months vs.22.2 months,and the 1-year OS rates were 10.0％ vs.39.6％ vs.74.4％ (P=0.000).Among the patients receiving postoperative adjuvant therapy,those treated with IORT+CRT had the best survival,with a median OS time of 11.6 months (P=0.033).The univariate analysis showed that IORT dose (P =0.000),tumor size (P =0.006),and IORT applicator diameter (P =0.007) were prognostic factors.The multivariate analysis showed that IORT dose (P=0.000) and IORT combined with CRT (P=0.006) were independent prognostic factors.Conclusions IORT with electron beam is an effective and safe treatment strategy for unresectable locally advanced pancreatic cancer.After protecting surrounding organs,increasing the IORT dose can improve the survival.IORT combined with CRT should be recommended because it improves survival for unresectable locally advanced pancreatic cancer without increasing toxicities.
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Soft tissue sarcoma ( STS) , which is mostly found in extremities and retroperitoneum, is a malignant tumor of the connective tissue with the low incidence ( 1% of all malignant tumors) and various kinds of histopathological types. Intraoperative radio-therapy ( IORT) can improve the therapeutic effects of STS and to reserve the functions of the related organs, holding the apparent ad-vantage in local control rate of the tumor. IORT may cause toxicity, such as wound infections, limb ischemic necrosis and fibrosis. However, with the gradual development of IORT equipment, incidence rate of toxicity may be further reduced. This paper reviews the history, indications and advantages, clinical efficacy and adverse effect of IORT in STS.
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Objective To evaluate the safety and feasibility of INTRABEAM in breast conserving surgery for early stage breast cancer.Methods Clinical data of 43 cases of early breast cancer undergoing INTRA-BEAM intraopetative radiotherapy from Jan.2013 to Dec.2014 were retrospectively analyzed.All cases underwent breast conserving surgery combined with 20 Gy INTRABEAM intraoperative radiotherapy.The postoperative incision,incidence of local complications and acute radiation injury were recorded after surgery.Breast recovery,the cosmetic effects,early overall survival,recurrence-free survival,and non-metastatic survival were followed up.Results All cases were given breast conserving surgery associated with INTRABEAM intraoperative radiotherapy (20 Gy),with median radiotherapy time of 31 mins ranging from 25 to 39 mins.Five cases underwent postoperative whole breast irradiation.Major early complications included incision infection (1 case),postoperative effusion (5 cases),radiation area skin pain (4 cases).The short-term follow-up survey showed that the satisfaction rate was 93.0％.The overall survival rate,recurrence free survival rate and metastasis free survival rate was 100％ respec tively.Conclusion Breast conseving surgery combined with INTRABEAM intraoperative radiotherapy for early breast cancer patients is safe and feasible.
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Currently,the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger.Due to the local changes of the tumor residual cavity after the breast conserving surgery,we can't accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount,and the course of treatment is longer.Intra-operative radiation therapy (IORT) can avoid the impact of respiratory motion and postural changes.Meanwhile,it can immediately irradiate the tumor bed intraoperative accurately.For patients,IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin and subcutaneous tissue.So IORT is convenient,easy to be accepted,and it has relatively few complications,good cosmetic results and so on.In recent years,more and more Cancer Center choose breast conserving surgery combined with IORT for the treatment of early stage breast cancer and do researches to the indications,methods,dosage,efficacy and prognosis of IORT.
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Breast cancer is the most common malignancy in women,which not only brings serious harm to female health but also substantially increased the burden of social medical care.Therefore it is necessary to adopt effective treatment strategies to control the social harm caused by cancer.Radiotherapy plays a critical role in the adjunctive therapy of breast cancer,which significantly reduces the risk of local recurrence and improves the long-term survival of breast cancer patients.In recent years,intraoperative radiotherapy has become a research hotspot in breast conserving surgery treatment,and is gradually applied in clinic with the advantage of mild side effect and shortening the patients′later treatment time.