Pazos Montserrat, Schönecker Stephan, Reitz Daniel, Rogowski Paul, Niyazi Maximilian, Alongi Filippo, Matuschek Christiane, Braun Michael, Harbeck Nadia, Belka Claus, Corradini Stefanie
Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.
Department of Radiation Oncology, Sacro Cuore Don Calbria Negrar, Verona, Italy.
Breast Care (Basel). 2018 Aug;13(4):285-291. doi: 10.1159/000488189. Epub 2018 May 24.
Radiation therapy (RT) for breast cancer has dramatically changed over the past years, leading to individualized risk-adapted treatment strategies. Historically, the choice of RT regimen was limited to conventional fractionation protocols using standard tangential fields. Nowadays, technological and technical improvements in modern RT have added a variety of other RT modalities, different fractionation schedules, and individualised treatment volumes to the portfolio of breast RT. This review aims to give a short overview on the main topics which have recently found their way into clinical practice: hypofractionated treatment protocols, accelerated partial breast irradiation (APBI) for low-risk patients, deep inspiration breath hold (DIBH) for maximal heart protection, extent of regional nodal irradiation for high-risk patients, and the implementation of new radiation techniques such as intensity modulated RT (IMRT) and volumetric modulated RT (VMAT).
在过去几年中,乳腺癌的放射治疗(RT)发生了巨大变化,从而产生了个体化的风险适应性治疗策略。从历史上看,RT方案的选择仅限于使用标准切线野的传统分割方案。如今,现代RT的技术改进为乳腺RT的方案增加了多种其他RT模式、不同的分割方案以及个体化的治疗体积。本综述旨在简要概述最近已应用于临床实践的主要主题:低分割治疗方案、针对低风险患者的加速部分乳腺照射(APBI)、为最大程度保护心脏的深吸气屏气(DIBH)、针对高风险患者的区域淋巴结照射范围,以及新放射技术如调强放疗(IMRT)和容积调强放疗(VMAT)的应用。