Henri Mondor Breast Center and Department of Radiation Oncology, APHP; University of Paris-Est Creteil (UPEC) and INSERM Unit 955 - Team 21. Creteil, France.
Department of Radiation Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, Canada.
Int J Radiat Oncol Biol Phys. 2020 Jul 1;107(3):437-448. doi: 10.1016/j.ijrobp.2020.04.012. Epub 2020 Apr 22.
Regional nodal irradiation has gained interest in recent years with the publication of several important randomized trials and the availability of more conformal techniques. Target volume delineation represents a critical step in the radiation planning process. Adequate coverage of the microscopic tumor spread to regional lymph nodes must be weighed against exposure of critical structures such as the heart and lungs. Among available guidelines for delineating the clinical target volume for the breast/chest wall and regional nodes, the Radiation Therapy Oncology Group and European Society for Radiotherapy and Oncology guidelines are the most widely used internationally. These guidelines have been formulated based on anatomic boundaries of areas historically covered in 2-dimensional field-based radiation therapy but have not been validated by patterns-of-failure studies. In recent years, an important body of data has emerged from mapping studies documenting patterns of local and regional recurrence. We aim to review, discuss, and compare contouring guidelines for breast cancer radiation therapy in the context of contemporary data on locoregional relapse to improve their implementation in modern practice.
近年来，随着几项重要的随机试验的发表和更适形技术的出现，区域淋巴结照射引起了人们的兴趣。靶区勾画是放射治疗计划过程中的关键步骤。必须权衡将微观肿瘤扩散到区域淋巴结的充分覆盖与对心脏和肺等关键结构的暴露。在用于勾画乳房/胸壁和区域淋巴结的临床靶区的现有指南中，放射治疗肿瘤学组和欧洲放射治疗和肿瘤学会指南在国际上应用最广泛。这些指南是基于历史上二维基于场放射治疗覆盖区域的解剖边界制定的，但尚未通过失败模式研究进行验证。近年来，从记录局部和区域复发模式的绘图研究中出现了大量重要数据。我们旨在回顾、讨论和比较乳腺癌放射治疗的轮廓指南，并结合局部区域复发的当代数据进行比较，以改进其在现代实践中的应用。
