乳房切除术后放射治疗 (PMRT) 可提高乳腺癌的无病生存率，但会降低审美满意度。 Proton PMRT 由于系统并发症较少而受到欢迎。缺乏关于放疗后基于胸前植入的乳房重建 (PP-IBBR) 翻修手术的数据。为了比较 PP-IBBR 的翻修手术与光子与质子 PMRT 的比较。一项单机构回顾性队列研究包括乳房接受乳房切除术和 PP-IBBR 联合 PMRT 的癌症患者（2020 年 1 月至 2022 年 10 月） 该队列的平均随访时间为 1056.4 天（2.89 年）。评估的修复手术包括脂肪移植、自体皮瓣转换、植入物置换、植入物去除、囊切除术和疤痕修复。116 PP-IBBR 分为两组：光子（75，64.66％）和质子（41，35.34％）辐射队列。光子的总体矫正手术率较高（总体为 27.5%；光子为 32.4%，质子为 19.5%，p=0.132）。使用光子进行翻修手术的几率几乎翻倍（OR=1.98），并且使用光子转换为自体皮瓣的可能性明显更高（OR=4.55，p=0.025）。多变量分析显示，光子治疗患者需要任何翻修手术（OR=1.62，p=0.359）、自体皮瓣（OR=5.97，p=0.049）、脂肪移植（OR=1.52，p=0.664）和疤痕手术的趋势增加翻修（OR=4.51，p=0.273）。与质子治疗相比，传统光子治疗PP-IBBR自体皮瓣的转化率更高。光子疗法的整体翻修手术率较高，但没有统计学意义。质子治疗更安全，翻修手术更少，需要更大规模的研究和更广泛的应用。© 作者 2024。由牛津大学出版社代表美学协会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

Postmastectomy radiation therapy (PMRT) improves disease-free survival in breast cancer but reduces aesthetic satisfaction. Proton PMRT has gained popularity due to fewer systemic complications. There is a lack of data regarding revision surgeries for pre-pectoral implant-based breast reconstruction (PP-IBBR) following radiation.To compare the revision surgeries in PP-IBBR with photon versus proton PMRT.A single-institution retrospective cohort study included breast cancer patients undergoing mastectomy and PP-IBBR with PMRT (January 2020-October 2022) The mean follow-up duration for the cohort was 1056.4 days (2.89 years). Revision surgeries evaluated were fat grafting, conversion to autologous flaps, implant replacement, implant removal, capsulectomy, and scar revision.116 PP-IBBR were divided into two cohorts: photon (75, 64.66%) and proton (41, 35.34%) radiation cohorts. Overall corrective surgeries were higher with photon (27.5% overall; 32.4% photon vs 19.5% proton, p=0.132). The odds of any revision surgery were nearly double with photon (OR=1.98), and the conversion to an autologous flap was significantly more likely with photon (OR=4.55, p=0.025). Multivariable analysis showed an increased tendency for photon therapy patients to require any revision surgeries (OR=1.62, p=0.359), autologous flaps (OR=5.97, p=0.049), fat grafting (OR=1.52, p=0.664) and scar revision (OR=4.51, p=0.273).Compared to proton therapy, traditional photon therapy has a higher conversion rate to autologous flaps with PP-IBBR. Photon therapy had higher rates of overall revision surgeries, however not statistically significant. Proton therapy is safer, with fewer revision surgeries, warranting larger studies and broader utilization.© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.