Our study aims to identify the risk factors and dosimetry characteristics associated with capsular contracture. Methods: We retrospectively analyzed 118 women with breast cancer who underwent PMRT following an IBR between 2010 and 2022. Patients were treated with PMRT of 50.0–50.4 Gy in 25–28 fractions. Capsular contracture was categorized according to the Baker Classification for Reconstructed Breasts. Results: After a median follow-up of 22 months, the incidence of clinically relevant capsular contracture (Baker III–IV) was 22.9%. Overall, capsular contracture (Baker I–IV) occurred in 56 patients (47.5%) after a median of 9 months after PMRT. The rate of reconstruction failure/implant loss was 25.4%. In the univariate analysis, postoperative complications (prolonged pain, prolonged wound healing, seroma and swelling) and regional nodal involvement were associated with higher rates of capsular contracture (p= 0.017, OR: 2.5, 95% CI: 1.2–5.3 andp= 0.031, respectively). None of the analyzed dosimetric factors or the implant position were associated with a higher risk for capsular contracture. Conclusion: Postoperative complications and regional nodal involvement were associated with an increased risk of capsular contracture following breast reconstruction and PMRT, while none of the analyzed dosimetric factors were linked to a higher incidence. Additional studies are needed to identify further potential risk factors.
本研究旨在明确与包膜挛缩相关的风险因素及剂量学特征。方法：我们回顾性分析了2010年至2022年间接受即刻乳房重建术后行胸壁放疗的118例乳腺癌患者。所有患者均接受总剂量50.0–50.4 Gy、分25–28次照射的胸壁放疗。包膜挛缩程度依据重建乳房贝克分级标准进行评估。结果：中位随访22个月后，临床相关包膜挛缩（贝克III–IV级）发生率为22.9%。总体而言，56例患者（47.5%）在胸壁放疗后中位9个月出现包膜挛缩（贝克I–IV级）。重建失败/假体取出率为25.4%。单因素分析显示，术后并发症（持续性疼痛、伤口愈合延迟、血清肿及肿胀）与区域淋巴结转移均与较高的包膜挛缩发生率相关（p=0.017，OR: 2.5，95% CI: 1.2–5.3；p=0.031）。所有分析的剂量学参数及假体位置均未显示与包膜挛缩风险增加相关。结论：术后并发症与区域淋巴结转移会增加乳房重建联合胸壁放疗后发生包膜挛缩的风险，而所分析的剂量学因素均与发生率升高无关。需进一步研究以明确其他潜在风险因素。
肿瘤(癌症)患者之家