Belaid A, Kanoun S, Kallel A, Ghorbel I, Azoury F, Heymann S, Pichenot C, Verstraet R, Marsiglia H, Bourgier C
Département de radiothérapie, Unité fonctionnelle de Sénologie, institut Gustave-Roussy, Villejuif, France.
Cancer Radiother. 2010 Nov;14 Suppl 1:S136-46. doi: 10.1016/S1278-3218(10)70017-2.
Breast cancer is the most frequent cancer of women in western countries. There are one million new cases per year in the world which represents 22% of all female cancers, and more than 370,000 deaths due to breast cancer per year (14% of cancer mortality). More than half of breast cancers are associated with axillary nodal involvement. Post-operative radiation therapy (XRT) is a crucial part of locoregional treatment in axillary nodal involvement breast cancer owing to a 15-years risk reduction of locoregional recurrence of 70% and to a 5.4% risk reduction of specific mortality. In 3D-conformal irradiation in such breast cancers, target volumes are chest wall when mastectomy was performed or breast and boost of tumor bed in case of breast conservative surgery, and supra-clavicular and/or axillary and/or internal mammary node areas. The main organs at risk are ipsilateral lung, heart and brachial plexus. The aim of this article is to describe epidemiologic, radio anatomic and prognostic features of axillary nodal involvement breast cancer and to propose guidelines for 3D-conformal treatment planning in locally advanced breast cancers. This review is illustrated by a case report.
乳腺癌是西方国家女性中最常见的癌症。全球每年有100万新发病例，占所有女性癌症的22%，每年因乳腺癌死亡人数超过37万（占癌症死亡率的14%）。超过一半的乳腺癌与腋窝淋巴结受累有关。术后放射治疗（XRT）是腋窝淋巴结受累乳腺癌局部区域治疗的关键部分，因为它可使局部区域复发风险在15年内降低70%，使特定死亡率降低5.4%。在这类乳腺癌的三维适形放疗中，若进行了乳房切除术，靶区为胸壁；若进行保乳手术，靶区为乳房及瘤床的增强区，以及锁骨上和/或腋窝和/或内乳淋巴结区域。主要危及器官为同侧肺、心脏和臂丛神经。本文旨在描述腋窝淋巴结受累乳腺癌的流行病学、放射解剖学和预后特征，并提出局部晚期乳腺癌三维适形治疗计划的指导原则。本综述通过一例病例报告进行说明。
