Department of Radiation Oncology, Perelman Center for Advanced Medicine, TRC 4 West, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Curr Oncol Rep. 2012 Feb;14(1):12-9. doi: 10.1007/s11912-011-0207-7.
Hypofractionated radiation refers to the use of fewer, larger-dose radiation treatments that are usually given over a shorter time period compared to conventional radiation fraction sizes. Randomized trials of hypofractionated whole breast irradiation (WBI) have demonstrated comparable outcomes as conventional fractionation. For a higher-risk population for local recurrence, a phase 3 trial by the Radiation Therapy Oncology Group (RTOG) is currently studying hypofractionated WBI with a concurrent tumor bed boost over 3 weeks. Accelerated partial breast irradiation limits radiation to the region of the tumor bed for 1-3 weeks and is the subject of an ongoing randomized trial by the National Surgical Breast and Bowel Project and RTOG. Questions remain for hypofractionation about optimal patient selection, radiation techniques, and the risk of late toxicity. But results from current trials could make hypofractionation more widely accepted for patients with early-stage breast cancer.
适形调强放疗是指使用较少的、较大剂量的放疗，与常规放疗分次剂量相比，通常在更短的时间内完成。适形调强全乳放疗的随机试验已经证明与常规分割具有相当的结果。对于局部复发风险较高的人群，放射治疗肿瘤学组（RTOG）目前正在进行一项 3 期临床试验，研究在 3 周内进行适形调强全乳放疗并同期进行肿瘤床加量。加速部分乳腺照射将放疗限制在肿瘤床区域 1-3 周，这是国家外科乳房和肠道项目和 RTOG 正在进行的一项随机试验的主题。关于适形调强的最佳患者选择、放疗技术和晚期毒性风险仍存在一些问题。但目前试验的结果可能使适形调强更广泛地被早期乳腺癌患者接受。
