Castaneda Serguei A, Strasser Jon
Department of Radiation Oncology, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, 4701 Ogletown-Stanton Road, S-1110, Newark, DE 19713, USA; Department of Radiation Oncology, Drexel University College of Medicine, 245 North 15th Street, MS #200, Philadelphia, PA 19102, USA.
Department of Radiation Oncology, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, 4701 Ogletown-Stanton Road, S-1110, Newark, DE 19713, USA; Department of Radiation Oncology, Drexel University College of Medicine, 245 North 15th Street, MS #200, Philadelphia, PA 19102, USA.
Surg Oncol Clin N Am. 2017 Jul;26(3):371-382. doi: 10.1016/j.soc.2017.01.013. Epub 2017 May 11.
Breast-conserving therapy is one of the most remarkable achievements of modern cancer care. The authors review the evidence supporting the role of adjuvant radiotherapy as the standard of care for breast cancer after breast-conserving surgery, consensus guidelines for margins in invasive cancer disease and ductal carcinoma in situ, the role of partial-breast irradiation and hypofractionated whole-breast irradiation, and the evolving indications for postmastectomy radiation therapy and extent of nodal coverage. Areas of research include specific methods of partial-breast irradiation, interactions between neoadjuvant chemotherapy and radiotherapy, and integration of molecular profiles with the selection of the best treatment modality and timing.
保乳治疗是现代癌症护理最显著的成就之一。作者回顾了支持辅助放疗作为保乳手术后乳腺癌护理标准作用的证据、浸润性癌和原位导管癌切缘的共识指南、部分乳腺照射和大分割全乳照射的作用,以及乳房切除术后放疗的不断演变的适应症和淋巴结覆盖范围。研究领域包括部分乳腺照射的具体方法、新辅助化疗与放疗之间的相互作用,以及分子特征与最佳治疗方式和时机选择的整合。