Impact of intraoperative radiotherapy vs. whole-breast external beam radiotherapy for early breast cancer: a propensity score matching study based on SEER database

被引：0

作者：

Ding, Lin ^{[1
]}

Mo, Huaqian ^{[1
]}

Yang, Yaping ^{[2
]}

Li, Qingjian ^{[3
]}

Bi, Zhuofei ^{[1
]}

Yang, Yaping ^{[2
]}

Bi, Zhuofei ^{[1
]}

机构：

[1] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Radiat Oncol, Yanjiang West Rd 107, Guangzhou 510120, Peoples R China

[2] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Breast Tumor Ctr, Yanjiang West Rd 107, Guangzhou 510120, Peoples R China

[3] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Oncol, Yanjiang West Rd 107, Guangzhou 510120, Peoples R China

来源：

GLAND SURGERY | 2025年 / 14卷 / 06期

基金：

中国国家自然科学基金;

关键词：

Early breast cancer; intraoperative radiotherapy (IORT); whole-breast external beam radiotherapy (WBRT); Surveillance; Epidemiology; and End Results (SEER); survival; CONSENSUS STATEMENT; IRRADIATION; LUMPECTOMY; OUTCOMES; BRACHYTHERAPY; SOCIETY; ELIOT;

D O I：

10.21037/gs-2025-52

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Breast-conserving surgery (BCS) followed by adjuvant whole-breast external beam radiotherapy (WBRT) is a standard treatment for early-stage breast cancer, effectively reducing local recurrence and improving survival. However, WBRT involves a prolonged treatment schedule and may lead to adverse effects and reduced patient compliance. Intraoperative radiotherapy (IORT), as a form of accelerated partial breast irradiation (APBI), offers a shorter treatment course by delivering a single dose of radiation during surgery. Although randomized controlled trials suggest comparable survival outcomes between IORT and WBRT in selected patients, real-world evidence is limited. This study aimed to compare the effects of IORT and WBRT on survival outcomes in early-stage breast cancer patients who underwent BCS, using a population-based dataset. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2019. Patients who received either IORT or WBRT after BCS were included. Overall survival (OS) and cancer-specific survival (CSS) were assessed using Kaplan-Meier methods. Cox proportional hazards regression was performed to identify independent prognostic factors. Results: There was no statistically significant difference in OS and CSS between the TORT and WBRT groups. Factors associated with worse survival included older age, T2 stage, and higher tumor grade (all P<0.01). Positive estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status were significantly associated with improved survival (all P<0.01). Conclusions: IORT is an effective alternative to WBRT with equivalent long-term survival. IORT may be considered for eligible patients based on age, tumor size, receptor status, and grade. Prospective studies are warranted to optimize the selection criteria.

引用

页码：1012 / 1023

页数：12

共 28 条

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