Sirák Igor, Hodek Miroslav, Jandík Pavel, Grepl Jakub, Paluska Petr, Petera Jiří
Department of Oncology and Radiotherapy, University Hospital and Medical Faculty, Hradec Králové, Czech Republic.
Department of Surgery, University Hospital, Hradec Králové, Czech Republic.
Transl Cancer Res. 2020 Jan;9(Suppl 1):S29-S36. doi: 10.21037/tcr.2019.07.03.
Breast-conserving surgery with adjuvant whole-breast irradiation has become the standard treatment for early breast cancer (EBC) patients. Partial breast irradiation, which targets only the postoperative cavity, has been established as an alternative to whole-breast therapy in selected patients. The treatment of elderly breast cancer patients differs from the therapeutic approach in younger ones, as elderly patients are prone to geriatric frailty and comorbid conditions, the incidence and severity of which increase with age. A review of the evidence, process, techniques, and results of accelerated partial breast irradiation (APBI) in elderly EBC patients, seems to indicate that APBI is an advisable postoperative approach in properly selected elderly EBC patients, combining advantages of a radical approach that minimizes the risk of undertreatment with efficient reduction of redundant irradiated volume, treatment toxicity, overall treatment time, staff workload, radiation technique workflow, patient transportation, and the potential for non-compliance. There is no "one size fits all" technique of APBI, the best technique always depending on willing patients, individual anatomy, performance status, patient frailty and comorbid conditions, and tumour location.
保乳手术联合辅助性全乳放疗已成为早期乳腺癌（EBC）患者的标准治疗方法。仅针对术后腔隙的部分乳腺放疗已被确立为特定患者全乳治疗的替代方案。老年乳腺癌患者的治疗方法与年轻患者不同，因为老年患者容易出现老年衰弱和合并症，其发病率和严重程度会随着年龄增长而增加。对老年EBC患者加速部分乳腺放疗（APBI）的证据、流程、技术和结果进行综述，似乎表明APBI对于经过适当选择的老年EBC患者是一种可取的术后治疗方法，它结合了根治性方法的优点，既能将治疗不足的风险降至最低，又能有效减少多余的照射体积、治疗毒性、总体治疗时间、工作人员工作量、放射技术流程、患者交通以及不依从的可能性。不存在一种适用于所有情况的APBI技术，最佳技术始终取决于患者意愿、个体解剖结构、身体状况、患者衰弱程度和合并症以及肿瘤位置。
