Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC 27514, USA.
Semin Radiat Oncol. 2011 Jan;21(1):66-78. doi: 10.1016/j.semradonc.2010.08.006.
Elective regional lymph nodal irradiation is controversial in patients with early stage breast cancer. Under the "Halstedian" model of tumor progression, elective nodal irradiation would be expected to provide some gain in both regional control and survival. Nevertheless, the data are inconclusive. When the axillary nodes are positive, there is uncertainty regarding the utility of elective irradiation of the supraclavicular and internal mammary areas. Similarly, in patients with a clinically negative axilla, the role of elective irradiation of the axilla and other nodal sites is also controversial. This article reviews data from trials that address the utility of elective regional nodal treatment, with regard to both tumor control (local control and survival) and morbidity.
选择性区域淋巴结照射在早期乳腺癌患者中存在争议。根据肿瘤进展的“哈尔斯特德模式”，选择性淋巴结照射有望在区域控制和生存方面都有所获益。然而，数据尚无定论。当腋窝淋巴结阳性时，对于锁骨上和内乳区域的选择性照射的效用存在不确定性。同样，对于临床腋窝阴性的患者，选择性照射腋窝和其他淋巴结部位的作用也存在争议。本文综述了关于选择性区域淋巴结治疗的效用的临床试验数据，涉及肿瘤控制（局部控制和生存）和发病率。
