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Abstract
Aim. To compare effect of intraoperative radiotherapy (IORT) and conventional external beam radiation therapy (EBRT) in the combined treatment of breast cancer (BC).
Materials and methods. The study was conducted in the Breast Cancer Unit of the Clinical Oncologic Dispensary No.1 of Krasnodar Territory. The main study group consisted of 104 patients who underwent breast-conserving surgery (BCS) in combination with IORT; the control group included 180 patients after combined treatment of BCS and routine EBRT. Cosmetic results of treatment were analyzed using a Harvard scale (4-point Likert scale), and late toxicity was assessed using the modified for BC LENT-SOMA scale. Statistical analysis was performed using the STATISTICA (v.10. Tibco, USA) analytics software.
Results. The relapse-free survival rate in women that received IORT and EBRT after 36-48 months of follow-up was 95.0% for the treatment group (median time 43±0.8 months) and 97.0% for the control group (median time 45±0.6 months), (p>0.05). Local relapses were diagnosed with almost the same frequency in both groups: 3.8% after IORT and 3.3% after EBRT. There was no significant difference in the cosmetic results of treatment between the groups. However, there was a significant decrease in the rate of skin hyperpigmentation after IORT compared to EBRT.
Conclusion. The use of IORT after BCS can significantly reduce radiation exposure, duration and cost of treatment, which is especially important for older patients, working women and those who live at a considerable distance from the medical unit. There was no statistically significant difference in the frequency of local relapses in the compared groups. The proposed combined method of cancer treatment reduces the incidence of late radiation complications, such as hyperpigmentation and fibrosis, and improves cosmetic results.
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