Breast-conserving surgery in breast cancer and intraoperative radiotherapy. Can we predict the fibrosis?

Autor: Vallejo Bernad C; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address: cristinavallejobernad@gmail.com., Casamayor Franco MDC; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España., Pérez-Tierra Ruiz JV; Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España., Martínez Lahoz Y; Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España., Carrasquer Puyal A; Servicio de Cirugía General y del Aparato Digestivo, Hospital de Barbastro, Barbastro, España., Pallarés Segura JL; Servicio de Cirugía General y del Aparato Digestivo, Hospital de Barbastro, Barbastro, España., Sánchez Marín JP; Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España., Barra Pardos MV; Servicio de Bioquímica Clínica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2019 Nov; Vol. 97 (9), pp. 517-522. Date of Electronic Publication: 2019 Jul 15.
DOI: 10.1016/j.ciresp.2019.05.012
Abstrakt: Introduction: Radiotherapy techniques associated with breast-conserving surgery have evolved in early breast cancer thanks to a better knowledge of tumor radiobiology, highlighting intraoperative radiotherapy (IORT). However, complications have been documented with this procedure, mainly fibrosis. Transforming growth factor beta (TGF-β) is a cytokine with an active role in radiation-induced fibrosis, which could be used as an early biomarker for the development of fibrosis.
Methods: Multicentric prospective analysis of 60 patients with breast cancer who underwent breast-conserving surgery, 30 of whom had received additional IORT. TGF-β values were evaluated in serum pre-surgery and in serum collected 24h after surgery. In addition, we evaluated surgical wound fluids collected 6h and 24h following surgery.
Results: Serum and surgical wound fluids TGF-β values collected over 24h following surgery were significantly higher in patients who received additional IORT (P<.0001). Notably, 8 of these patients showed values above 1,000pg/ml. There were no differences between the samples (serum or surgical wound fluids) (P=.5881).
Conclusions: Although further investigation is needed, higher TGF-β values in IORT during breast-conserving surgery can be used as an early biomarker for the development of fibrosis.
(Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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