Horton Janet K, Jagsi Reshma, Woodward Wendy A, Ho Alice
Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Int J Radiat Oncol Biol Phys. 2018 Jan 1;100(1):23-37. doi: 10.1016/j.ijrobp.2017.08.025.
Historically, prognosis and treatment decision making for breast cancer patients have been dictated by the anatomic extent of tumor spread. However, in recent years, "breast cancer" has proven to be a collection of unique phenotypes with distinct prognoses, patterns of failure, and treatment responses. Recent advances in biologically based assays and targeted therapies designed to exploit these unique phenotypes have profoundly altered systemic therapy practice patterns and treatment outcomes. Data associating locoregional outcomes with tumor biology are emerging. However, the likelihood of obtaining level I evidence for fundamental radiation therapy questions within each of the specific subtypes in the immediate future is low. As such, this review aims to summarize the existing data and provide practical context for the incorporation of breast tumor biology into clinical practice.
从历史上看，乳腺癌患者的预后和治疗决策一直取决于肿瘤扩散的解剖范围。然而，近年来，“乳腺癌”已被证明是一系列具有独特预后、失败模式和治疗反应的独特表型的集合。基于生物学的检测方法和旨在利用这些独特表型的靶向治疗的最新进展，已深刻改变了全身治疗的实践模式和治疗结果。将局部区域治疗结果与肿瘤生物学相关联的数据正在不断涌现。然而，在不久的将来，针对每个特定亚型的基本放射治疗问题获得一级证据的可能性较低。因此，本综述旨在总结现有数据，并为将乳腺肿瘤生物学纳入临床实践提供实际背景。
