Patel Rakesh R, Das Rupak K
Department of Human Oncology, University of Wisconsin, 600 Highland Avenue, K4/B100 CSC Madison, WI 53792, USA.
Lancet Oncol. 2006 May;7(5):407-15. doi: 10.1016/S1470-2045(06)70692-1.
Lumpectomy and whole-breast radiotherapy (ie, breast-conservation treatment) are accepted as viable alternatives to mastectomy in locoregional management of breast cancer. These techniques are used to keep morbidity to a minimum, optimise cosmesis, and maintain treatment outcomes. Pathological and clinical data suggest that most recurrences of cancer in the ipsilateral breast are in the vicinity of the index lesion, and that remote recurrences are uncommon, whether or not whole-breast radiotherapy is delivered. These data lend support to the idea of partial-breast radiotherapy. Such a restricted treatment volume allows safe delivery of an accelerated hypofractionated regimen over a shortened course of 1 week. This technique differs from that of standard whole-breast tangential external-beam radiotherapy and necessitates investigation of accelerated partial-breast irradiation (APBI). Several techniques of APBI are being investigated; however, most experience, and the most favourable early outcomes, has been obtained with image-guided breast brachytherapy. This review highlights the rationale and outcomes of brachytherapy techniques.
保乳手术和全乳放疗（即保乳治疗）在乳腺癌局部区域治疗中被认为是乳房切除术可行的替代方案。这些技术用于将发病率降至最低、优化美容效果并维持治疗效果。病理和临床数据表明，无论是否进行全乳放疗，同侧乳房的大多数癌症复发都发生在索引病灶附近，远处复发并不常见。这些数据支持了部分乳腺放疗的理念。如此受限的治疗体积允许在短短1周的疗程内安全地实施加速分割放疗方案。该技术不同于标准的全乳切线外照射放疗技术，因此有必要对加速部分乳腺照射（APBI）进行研究。目前正在研究几种APBI技术；然而，大多数经验以及最有利的早期结果是通过图像引导的乳腺近距离放射治疗获得的。本综述重点介绍了近距离放射治疗技术的基本原理和结果。
