Kacprowska Agata, Jassem Jacek
Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland.
Rep Pract Oncol Radiother. 2012 Feb 1;17(2):66-70. doi: 10.1016/j.rpor.2011.10.003.
Breast-conserving surgery including whole breast irradiation has long been a recommended procedure for early breast cancer. However, conventionally fractionated radiotherapy requires a lengthy hospitalisation or prolonged commuting to a hospital for radiotherapy. In recent years, hypofractionated radiotherapy has increasingly been used. This method involves higher fraction doses (above 2 Gy) as compared to conventional radiotherapy, so the total dose can be delivered in fewer fractions and in a shorter overall treatment time. This review aims at presenting most important outcomes of four randomised studies comparing conventional and hypofractionated radiotherapy schemes including a total of 7000 patients. These studies have not shown apparent differences in treatment efficacy, incidence of late post-radiotherapy complications or cosmetic effects during a 5-10 year follow-up, but longer observation is warranted to fully evaluate the safety of this method. Currently, major societies consider modestly hypofractionated radiotherapy schemes as a routine management in selected groups of patients undergoing breast-conserving surgery. However, this method should be used cautiously in patients with lymph node metastases, big breasts, receiving chemotherapy or trastuzumab, or those under 50 years of age.
包括全乳照射在内的保乳手术长期以来一直是早期乳腺癌的推荐治疗方法。然而，传统分割放疗需要长时间住院或往返医院接受放疗。近年来，大分割放疗的应用越来越广泛。与传统放疗相比，这种方法每次分割剂量更高（超过2Gy），因此总剂量可以通过更少的分割次数和更短的总治疗时间来给予。本综述旨在介绍四项比较传统和大分割放疗方案的随机研究的最重要结果，这些研究共纳入了7000例患者。这些研究在5至10年的随访中未显示出治疗效果、放疗后晚期并发症发生率或美容效果方面的明显差异，但需要更长时间的观察以全面评估该方法的安全性。目前，主要学会认为适度的大分割放疗方案是保乳手术特定患者群体的常规治疗方法。然而，对于有淋巴结转移、乳房较大、接受化疗或曲妥珠单抗治疗的患者或50岁以下的患者，应谨慎使用该方法。
