Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.
Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milano, Italy.
Am J Clin Oncol. 2023 Jan 1;46(1):2-6. doi: 10.1097/COC.0000000000000945. Epub 2022 Oct 17.
Partial breast irradiation (PBI) has been demonstrated to have comparable outcomes to whole breast irradiation based on multiple randomized trials with long-term follow-up. However, despite the strength of the data available, PBI remains underutilized despite being an appropriate option for many women diagnosed with early-stage breast cancer. This is significant, as PBI offers the potential to reduce toxicities and shorten treatment duration without impacting outcomes; in addition, for low-risk patients, PBI alone is being investigated as an alternative to endocrine therapy alone. Modern PBI can be delivered with multiple techniques, and advances in treatment planning have allowed for improved therapeutic ratios compared with earlier techniques; one such approach is utilizing stereotactic body radiation therapy approaches allowing for smaller target margins and therefore lower breast doses. Moving forward, studies are ongoing evaluating the use of radiation alone including PBI as compared with endocrine therapy alone, with prospective studies evaluating stereotactic body radiation therapy.
部分乳房照射（PBI）已被多项具有长期随访的随机试验证明与全乳照射具有可比的结果。然而，尽管现有数据的强度很大，但尽管对于许多诊断为早期乳腺癌的女性来说是一个合适的选择，PBI 的应用仍然不足。这很重要，因为 PBI 有可能在不影响结果的情况下降低毒性并缩短治疗时间；此外，对于低风险患者，正在研究单独使用 PBI 作为内分泌治疗的替代方案。现代 PBI 可以采用多种技术进行治疗，并且治疗计划的进步使得与早期技术相比，治疗比得到了改善；一种这样的方法是利用立体定向体部放射治疗方法，从而允许更小的靶区边缘，因此降低乳房剂量。未来，正在进行评估单独使用放射治疗（包括 PBI）与单独使用内分泌治疗的研究，前瞻性研究正在评估立体定向体部放射治疗。
