State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2021 Dec;26:18-35. doi: 10.33145/2304-8336-2021-26-18-35.
The analysis of long-term researches of the pathological changes arising in soft tissues at patients with a breast cancer as a result of radical surgical treatment and adjuvant radiotherapy is carried out in work. The article shows that the standard approach to postoperative radiation therapy, which is based only on the prevalence of the primary tumor process is not always justified. Very often it leads to excessive radiation load on the patient's body and the development of local acute and chronic radiation reactions of the skin, subcutaneous tissue and other soft tissues.In this regard, the question of differentiated purpose of radiotherapy acquires special value first of all at patients with small primary prevalence of tumor process. The paper presents the results of studies to study changes in the anterior chest wall in patients with breast cancer. In relation to the conduct of adjuvant radiotherapy more often need to use the concept of personalized radiation therapy. Radical operation, post-radiation early and late pathological changes in soft tissues, disturbance of microcirculation of lymph and blood, disturbance of innervation of vessels of an upper extremity, peripheral nerves in system of a cervical and plexus plexus, leads to intensive degen-erative and dystrophic changes in soft tissues of the upper. and causes morphological changes in them and further progression of reflex neurovascular and neurodystrophic disorders. Based on the data of adverse effects of radio-therapy on the skin and surrounding tissues, as well as to reduce excessive radiation exposure to the patient's body, a differentiated approach to the appointment of adjuvant radiation therapy.
工作中对乳腺癌患者根治性手术和辅助放疗后软组织病变的长期研究进行了分析。文章表明,基于原发性肿瘤过程流行率的标准术后放射治疗方法并不总是合理的。它常常导致患者身体的辐射负荷过大,并导致皮肤、皮下组织和其他软组织的局部急性和慢性辐射反应。因此,在肿瘤过程原发性流行率较小的患者中,放疗的差异化目的问题首先具有特殊的价值。本文介绍了对乳腺癌患者前胸壁变化的研究结果。在进行辅助放疗方面,更需要使用个性化放疗的概念。根治性手术、放疗后的早期和晚期软组织变化、淋巴和血液微循环紊乱、上肢血管和颈部和丛丛的神经支配紊乱,导致上肢软组织的强烈退行性和营养不良性变化,并导致其形态学变化,进一步发展为反射性神经血管和神经营养不良障碍。基于放疗对皮肤和周围组织的不良反应的数据,以及为了减少患者身体的过度辐射暴露,对辅助放疗的应用采用了差异化方法。