Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Lancet Oncol. 2012 Jun;13(6):e270-6. doi: 10.1016/S1470-2045(12)70038-4.
Whereas randomised clinical trials have established which patients might benefit from postmastectomy radiation therapy after upfront surgery, no such data exist for guiding decisions on who might benefit from postmastectomy radiation therapy after upfront chemotherapy. Insight must be drawn from non-randomised data to provide such guidance. Early data suggest that both extent of disease at presentation and response to neoadjuvant chemotherapy predict the risk of locoregional recurrence, and can be used to tailor recommendations for postmastectomy radiation therapy. Randomised clinical trial data are needed to assess whether postmastectomy radiation therapy can be safely omitted in selected women with good response to neoadjuvant chemotherapy.
虽然随机临床试验已经确定了哪些患者在 upfront 手术后可能受益于术后放疗，但没有数据可以指导哪些患者在 upfront 化疗后可能受益于术后放疗。必须从非随机数据中获取这种指导。早期数据表明，发病时疾病的范围和对新辅助化疗的反应都可以预测局部区域复发的风险，并可用于为术后放疗制定建议。需要随机临床试验数据来评估对于新辅助化疗反应良好的特定女性是否可以安全地省略术后放疗。
