Moran Meena S
Therapeutic Radiology, Yale Radiation Therapy Program, Yale University School of Medicine, New Haven, USA.
Cancer Treat Res. 2018;173:89-119. doi: 10.1007/978-3-319-70197-4_7.
Significant technologic advances in radiation treatment delivery now allow for more personalized delivery considerations which incorporate individual patient characteristics (such as tumor location and patient anatomy) and more precise delivery in the breast conservation or post-mastectomy setting. The combined advancements with other treatment modalities (i.e., systemic therapy, surgical management) have had direct effects on local-regional management and outcomes such that currently, local-regional relapses after definitive treatment for localized disease are now rarely experienced. Recent advances in the radiation therapy field have come from careful patient selection for a variety of three-dimensional treatment delivery techniques and alternatives to conventional tangential radiation. These advances have been demonstrated to diminished acute/long-term toxicity, minimized dose to surrounding normal tissue structures such as the heart and lung, and ultimately result in an improvement in the therapeutic ratio for radiation treatment. This chapter discusses recent radiation innovations and appropriate patient selection for their application, for a more personalized approach to radiation therapy for breast cancer patients.
放射治疗技术的重大进展使得在制定放射治疗方案时能够更多地考虑个性化因素，这些因素包括患者的个体特征（如肿瘤位置和患者解剖结构），并能在保乳或乳房切除术后的情况下实现更精确的放射治疗。与其他治疗方式（即全身治疗、手术管理）的联合进展对局部区域治疗和结果产生了直接影响，以至于目前，针对局部疾病进行确定性治疗后很少出现局部区域复发的情况。放射治疗领域的最新进展来自于对各种三维放射治疗技术进行仔细的患者选择以及对传统切线放射治疗的替代方案。这些进展已被证明可以减少急性/长期毒性，将对心脏和肺等周围正常组织结构的剂量降至最低，并最终提高放射治疗的治疗比。本章将讨论放射治疗的最新创新以及适用于这些创新的患者选择，以便为乳腺癌患者提供更个性化的放射治疗方法。
