Presented by Kilian E. Salerno, MD, Breast Radiation and Soft Tissue/Melanoma Radiation, Roswell Park Cancer Institute.
J Natl Compr Canc Netw. 2017 May;15(5S):682-684. doi: 10.6004/jnccn.2017.0072.
In the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer, among adjuvant radiotherapy options for whole-breast irradiation after breast-conserving surgery, hypofractionation is preferred. For the use of accelerated partial-breast irradiation, the NCCN Guidelines have adopted the updated definition of "suitability" used by the American Society for Radiation Oncology. Regional nodal irradiation is indicated-either in the setting of breast-conserving surgery or after mastectomy-for women with ≥4 positive nodes and should be strongly considered for 1 to 3 positive lymph nodes and select patients with node-negative disease deemed at high risk for recurrence.
在 NCCN 肿瘤学临床实践指南(NCCN 指南)中,对于保乳手术后全乳照射的辅助放疗选择,采用了分次放疗。对于加速部分乳腺照射的应用,NCCN 指南采用了美国放射肿瘤学会更新的“适用性”定义。对于阳性淋巴结≥4 个的患者,无论是保乳手术后还是乳房切除术后,均建议进行区域淋巴结照射,对于 1 至 3 个阳性淋巴结的患者,应强烈考虑进行区域淋巴结照射,对于淋巴结阴性但复发风险高的患者也应考虑进行区域淋巴结照射。