Inverse radiotherapy planning in reconstructive surgery for breast cancer

INTERNATIONAL JOURNAL OF SURGERY

卷:63

Article

Tejera Hernandez, Ana Alicia^1,2  Vega Benitez, Victor Manuel^1,2  Rocca Cardenas, Juan Carlos¹  Ortega Perez, Neith^1,2  Rodriguez Ibarria, Nieves^1,3  Gutierrez Giner, Maria Isabel^1,2  Perez Correa, Pedro^1,2  Diaz Chico, Juan Carlos¹  Hernandez Hernandez, Juan Ramon^1,2 

[1] Univ Las Palmas Gran Canaria, Calle Juan Quesada 30, Las Palmas Gran Canaria 35001, Las Palmas, Spain

[2] Hosp Univ Insular Gran Canaria, Complejo Hosp Univ Insular Materno Infantil, Gen Surg Dept, Av Maritima Sur, Las Palmas Gran Canaria 35016, Las Palmas, Spain

[3] Hosp Univ Gran Canaria Dr Negrin, Therapeut Radiat & Oncol Dept, Las Palmas Gran Canaria 35010, Las Palmas, Spain

关键词: Breast cancer;    Post-mastectomy radiotherapy;    Aesthetic results;    Satisfaction degree;   

DOI  :  10.1016/j.ijsu.2019.01.017

来源: Elsevier

【 摘 要 】

Background: Post-mastectomy radiotherapy reduces the risk of local-regional relapse and distant disease, and increases global survival in women with axillary involvement. With the new reconstruction techniques and increasing use of directed external radiotherapy, immediate reconstruction can be performed with good cosmetic results and low complication rates. Materials and methods: Observational study with consecutive sampling conducted in patients undergoing reconstructive surgery for breast cancer, between 2010 and 2016, with a 12-months minimum follow-up period. A group of patients radiated after receiving an expander (RT-Expander) were compared with a control group of non-radiated patients (Non-RT), who had been treated with the same surgical technique. We compare general complications, reconstruction failure, aesthetic results and satisfaction degree with software IBM (R) SPSS (R) Statistics v. 21 and BREAST-Q scores. Results: Reconstruction failure was observed in 15.6% of patients in a similar proportion in both groups. External radiotherapy was not an independent significant factor influencing the occurrence of general complications, capsular contracture grade >= 3 or reconstruction failure. The Kaplan-Meyer curve showed no differences in reconstruction survival between groups. Aesthetic results were excellent-very good in 78.1% of patients. Absence of a contralateral procedure for symmetrization, occurrence of general complications, occurrence of capsular contracture grade >= 3 and reconstruction failure were significantly associated to fair-poor cosmetic results. The satisfaction degree of operated patients was similar in both groups. Conclusions: The evolution of external radiotherapy towards more directed techniques, which modulate the dose administered to the mammary tissue and adjacent structures, allowed us to make immediate reconstruction a reality for most patients, with complication rates, cosmetic results and satisfaction degrees similar to those of non-radiated patients.

【 授权许可】

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