BRCA1/2、TP53、ATM基因突变的乳腺癌辅助放疗：是否存在已解决的问题？
Breast Cancer Adjuvant Radiotherapy in BRCA1/2, TP53, ATM Genes Mutations: Are There Solved Issues?
作者信息
Lazzari Grazia, Buono Giuseppe, Zannino Benedetto, Silvano Giovanni
机构信息
Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, 74100, Italy.
Medical Oncology Unit, San Rocco Hospital, Sessa Aurunca, Caserta, 81037, Italy.
出版信息
Breast Cancer (Dove Med Press). 2021 May 12;13:299-310. doi: 10.2147/BCTT.S306075. eCollection 2021.
Abstract
BRCA1, BRCA2, TP53 and ATM gene mutations are the most studied tumour suppressor genes (TSGs) influencing the loco-regional approach to breast cancer (BC). Due to altered radio sensitivity of mutated cancer cells, mastectomy has always been advised in most patients with BC linked to TSGs mutations in order to avoid or minimize the use of adjuvant radiotherapy (ART). Whether ART is safe or not in these carriers is still debated. As a result, this issue has been widely discussed in the recent ASTRO and ASCO papers, yielding important and useful recommendations on the use of ART according to the mutational status. In this review, we have highlighted the impact of these mutations on local control, toxicities, second tumors, and contralateral breast cancers (CBCs) after ART to solve remaining doubts and encourage the safe use of ART when indicated.
摘要
BRCA1、BRCA2、TP53和ATM基因突变是研究最多的影响乳腺癌（BC）局部治疗方法的肿瘤抑制基因（TSG）。由于突变癌细胞的放射敏感性改变，对于大多数与TSG突变相关的BC患者，一直建议行乳房切除术，以避免或尽量减少辅助放疗（ART）的使用。在这些携带者中ART是否安全仍存在争议。因此，这个问题在最近的美国放射肿瘤学会（ASTRO）和美国临床肿瘤学会（ASCO）的论文中得到了广泛讨论，就根据突变状态使用ART提出了重要且有用的建议。在本综述中，我们强调了这些突变对ART后局部控制、毒性、第二原发肿瘤和对侧乳腺癌（CBC）的影响，以解决尚存的疑问，并鼓励在有指征时安全使用ART。
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