Everett Ashlyn S, Boggs Drexell Hunter, De Los Santos Jennifer F
Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
Hazelrig Salter Radiation Oncology Center, 1700 6th Ave South, Birmingham, AL 35249, USA.
Int J Breast Cancer. 2018 Mar 1;2018:1402824. doi: 10.1155/2018/1402824. eCollection 2018.
Contemporary recommendations for postmastectomy radiation have undergone a shift in thinking away from simple stage based recommendations (one size fits all) to a system that considers both tumor biology and host factors. While surgical staging has traditionally dictated indications for postmastectomy radiation therapy (PMRT), our current understanding of tumor biology, host, immunoprofiles, and tumor microenvironment may direct a more personalized approach to radiation. Understanding the interaction of these variables may permit individualization of adjuvant therapy aimed at appropriate escalation and deescalation, including recommendations for PMRT. This article summarizes the current data regarding tumor and host molecular biomarkers and that support the individualization of PMRT and discusses open questions that may alter the future of breast cancer treatment.
当代关于乳房切除术后放疗的建议已经经历了思维转变，从简单的基于分期的建议（一刀切）转向一种同时考虑肿瘤生物学和宿主因素的系统。虽然传统上手术分期决定了乳房切除术后放射治疗（PMRT）的适应症，但我们目前对肿瘤生物学、宿主、免疫谱和肿瘤微环境的理解可能会引导一种更个性化的放疗方法。了解这些变量之间的相互作用可能有助于实现辅助治疗的个体化，包括适当的强化和降级，其中就包括PMRT的建议。本文总结了目前关于肿瘤和宿主分子生物标志物的数据，这些数据支持PMRT的个体化，并讨论了可能改变乳腺癌治疗未来的悬而未决的问题。
