De Felice Francesca, Osti Mattia Falchetto, De Sanctis Vitaliana, Musio Daniela, Tombolini Vincenzo
a Department of Radiotherapy , Policlinico Umberto I, "Sapienza" University of Rome , Rome , Italy.
b Department of Medicine and Surgery and Translational Medicine , Unit of Radiotherapy, S Andrea Hospital, "Sapienza" University of Rome , Rome , Italy.
Expert Rev Anticancer Ther. 2017 May;17(5):481-485. doi: 10.1080/14737140.2017.1305897. Epub 2017 Mar 16.
In breast cancer management, the role of adjuvant radiation therapy (RT) has been the subject of intense controversy over the past several years, due to the improvement in neoadjuvant chemotherapy (NACT) prescription. One of the most controversial questions regarding indication for adjuvant RT is whether or not RT is essential in patients with early stage disease at diagnosis. The value of adjuvant RT remains highly debatable in those patients with clinically negative nodes at the completion of NACT. Areas covered: This review is focused on this gray area and is intended to assist with clinical decision-making. We provide a comprehensive review using PubMed and meeting proceedings of San Antonio Breast Cancer Symposium, European Society for Radiotherapy & Oncology, European Society of Medical Oncology and American Society of Clinical Oncology. Expert commentary: The identification of potential prognostic factors may lead to novel adjuvant RT indications. Phase III clinical trials are underway and their results will help guide treatment decisions.
在乳腺癌治疗中，由于新辅助化疗（NACT）方案的改进，辅助放疗（RT）的作用在过去几年一直是激烈争论的焦点。关于辅助放疗适应症最具争议的问题之一是，对于诊断时处于疾病早期的患者，放疗是否必不可少。在新辅助化疗结束时临床淋巴结阴性的患者中，辅助放疗的价值仍存在高度争议。涵盖领域：本综述聚焦于这一灰色地带，旨在协助临床决策。我们使用PubMed以及圣安东尼奥乳腺癌研讨会、欧洲放射治疗与肿瘤学会、欧洲医学肿瘤学会和美国临床肿瘤学会的会议记录进行了全面综述。专家评论：潜在预后因素的识别可能会带来新的辅助放疗适应症。三期临床试验正在进行中，其结果将有助于指导治疗决策。
