乳房再造的类型影响放射治疗的结果

根据一项发表在11月号的研究，对于接受乳房切除术并在立即乳房重建后接受放射治疗的乳腺癌患者，自体组织重建比组织扩张和植入重建提供更少的长期并发症和更好的美容效果国际辐射肿瘤学*生物学*物理学，美国治疗放射学和肿瘤学会的官方杂志。

在进行乳房切除术后（乳房外切除）后，许多女性选择乳房重建程序立即进行，以更好地应对手术的心理和美学副作用。然而，重建可以使放射治疗治疗复杂化，有时辐射会对重建的结果产生负面影响，并增加长期并发症的风险。

随着放射治疗越来越多地成为乳房切除术后高危乳腺癌患者的护理标准，这可能导致患者及其放射肿瘤学家的问题。

Researchers at the Department of Radiation Oncology at Long Island Radiation Therapy in Garden City, N.Y., the Department of Surgery at Long Island Jewish Hospital in New Hyde Park, N.Y., the Department of Surgery at North Shore University Hospital in Manhasset, N.Y., and the Department of Surgery at Winthrop University Hospital in Mineola, N.Y., sought to determine if the type of reconstruction performed on women who were receiving radiation after a mastectomy had an impact on their long-term outcomes.

对于接受乳房切除术的乳腺癌患者，有两种类型的乳房重建:ATR(自体组织重建)，包括放置组织瓣——通常来自腹横直肌——作为乳房隆起，TE/I(组织扩张器和植入物重建)，这包括在胸壁上放置一个可膨胀的组织扩张器，并在以后更换一个永久性的植入物。

本研究涉及最大的报告系列患者依次进行乳房切除，即时重建和后切除辐射治疗。在重建和放射治疗后38个月观察了九十二名患者，研究人员发现ATR通过乳腺癌患者更好地耐受，因为它与比TE / I更少的长期并发症和更好的化妆品结果相关。

23例ATR患者中没有一例需要手术干预，而33%的TE/I患者需要手术纠正重建中的问题。83%的ATR患者报告了可接受的美容结果，而只有54%的TE/I患者报告了可接受的美容结果。

"This study is useful for patients who are candidates for either ATR or TE/I and are making a decision with regards to reconstruction technique," Jigna Jhaveri, M.D., lead author of the study and a radiation oncologist at Advanced Radiation Centers of New York in Hauppauge, N.Y., said. "Our study provides evidence that patients who undergo autologous tissue reconstruction and radiation therapy have fewer long term complications and better cosmetic outcomes than those who undergo tissue expander/ implant reconstruction and radiation therapy."

资料来源：美国治疗放射学和肿瘤学会

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