Atean I, Pointreau Y, Barillot I, Kirova Y-M
Service de radiothérapie, centre régional universitaire de cancérologie Henry-S.-Kaplan, hôpital Bretonneau, CHRU de Tours, France.
Cancer Radiother. 2012 Sep;16(5-6):485-92. doi: 10.1016/j.canrad.2012.06.002. Epub 2012 Aug 24.
Adjuvant radiotherapy is a standard component of breast cancer treatment. The addition of radiotherapy after breast conserving surgery has been shown to reduce local recurrence rate and improve long-term survival. Accurate delineation of target volumes and organs at risk is crucial to the quality of treatment planning and delivered accomplished with innovate technologies in radiation therapy. This allows the radiation beam to be shaped specifically to each individual patient's anatomy. Target volumes include the mammary gland and surgical bed in case of breast conserving surgery, the chest wall in case of mastectomy, and if indicated, regional lymph nodes (axillary, supra- and infraclavicular and internal mammary). Organs at risk include lungs, thyroid, brachial plexus, heart, spinal cord and oesophagus. The aim of this article is to encourage the use of conformal treatment and delineation of target volumes and organs at risk and to describe specifically the definition of these volumes.
辅助放疗是乳腺癌治疗的标准组成部分。保乳手术后加用放疗已被证明可降低局部复发率并提高长期生存率。准确勾画靶区体积和危及器官对于治疗计划的质量至关重要,并且借助放射治疗中的创新技术得以实现。这使得辐射束能够根据每个患者的解剖结构进行专门塑形。靶区体积在保乳手术时包括乳腺和手术床,在乳房切除时包括胸壁,如有指征还包括区域淋巴结(腋窝、锁骨上下和内乳淋巴结)。危及器官包括肺、甲状腺、臂丛神经、心脏、脊髓和食管。本文的目的是鼓励使用适形治疗并勾画靶区体积和危及器官,具体描述这些体积的定义。