Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA; The Morgan Welch IBC Clinic and Research Program, UT MD Anderson Cancer Center Houston, TX, USA.
Chin Clin Oncol. 2021 Dec;10(6):60. doi: 10.21037/cco-21-153.
This review highlights the considerations of the radiation oncologist when managing patients with inflammatory breast cancer (IBC) as well as the radiation oncologist's role as a member of the multi-disciplinary team.
IBC makes up only 1-4% of all breast cancer diagnoses but incidence is increasing. IBC is diagnosed based on a constellation of clinical features, including the rapid onset of breast erythema and edema (peau d'orange) of one-third or more of the skin of the breast and with a palpable border to the edema. Most published IBC local-regional control rates are consistently lower than those observed in non-IBC, which the highlights the need for deliberate treatment techniques to maximize clinical outcomes.
For this narrative review, we discuss the principles of radiation target delineation and dose escalation; highlight new findings in the local-regional management of IBC; provide a critical evaluation of the recent literature evaluating local-regional treatment of IBC; and offer a brief introduction to possible future directions regarding the optimal treatment and management of IBC based on our institutional experience.
IBC is an aggressive type of breast cancer that warrants multi-disciplinary care from breast surgical, medical, and radiation oncology. Several strategies exist to enhance the effect of radiation therapy (RT) on local-regional control, including hyperfractionation, use of bolus, increased total RT dose, and radiosensitizers, which are currently being tested in randomized trials. With an individualized patient approach, local-regional control rates are improving for IBC.
本文重点介绍了放射肿瘤学家在管理炎性乳腺癌（IBC）患者时的注意事项，以及放射肿瘤学家作为多学科团队成员的作用。
IBC 仅占所有乳腺癌诊断的 1-4%，但发病率正在上升。IBC 的诊断基于一系列临床特征，包括三分之一或更多乳房皮肤的红斑和水肿（橘皮样变）的迅速出现，以及水肿的可触及边界。大多数已发表的 IBC 局部区域控制率始终低于非 IBC 观察到的水平，这突出了需要精心设计治疗技术以最大程度地提高临床结果。
对于这篇叙述性综述，我们讨论了放射靶区勾画和剂量递增的原则；强调了 IBC 局部区域管理方面的新发现；对评估 IBC 局部区域治疗的最新文献进行了批判性评估；并根据我们的机构经验，简要介绍了关于 IBC 最佳治疗和管理的可能未来方向。
IBC 是一种侵袭性乳腺癌，需要来自乳腺外科、内科和放射肿瘤学的多学科治疗。有几种策略可以增强放射治疗（RT）对局部区域控制的效果，包括超分割、使用填充物、增加总 RT 剂量和放射增敏剂，这些策略目前正在随机试验中进行测试。通过个体化的患者治疗方法，IBC 的局部区域控制率正在提高。
