Kim Nalee, Kim Yong Bae
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2022 Dec;40(4):216-224. doi: 10.3857/roj.2022.00577. Epub 2022 Dec 26.
Historical conventional fractionated radiation therapy (RT) for breast cancer consisted of 1.8-2.0 Gy per fraction with a total dose of 45-60 Gy over 5-7 weeks. Based on radiobiological characteristics, a low α/β is suspected of breast cancer resulting in sensitivity to higher dose per fraction (2.5-3.0 Gy). Over the past 10 years, multiple clinical trials support the application of shorter treatment regimen with hypofractionated RT (HypoRT). Recently, ultra-HypoRT with 5 fractions showed favorable outcomes. Although the safety and efficacy of HypoRT has been supported by high-quality randomized trials, there are still some worries and doubts around HypoRT from radiation oncologists. However, the radiation oncology community have now reached an important timepoint for adopting HypoRT during the COVID-19 pandemic. The aim of this review is to provide an overview of HypoRT in breast cancer based on prospective randomized trials and discuss the special consideration regarding HypoRT.
乳腺癌的传统分次放射治疗（RT）是每次给予1.8 - 2.0 Gy，在5 - 7周内总剂量达到45 - 60 Gy。基于放射生物学特性，推测乳腺癌的α/β比值较低，这导致其对每次较高剂量（2.5 - 3.0 Gy）敏感。在过去10年中，多项临床试验支持应用短疗程的大分割放射治疗（HypoRT）。最近，5次分割的超短程大分割放射治疗显示出良好的效果。尽管大分割放射治疗的安全性和有效性已得到高质量随机试验的支持，但放射肿瘤学家对大分割放射治疗仍存在一些担忧和疑虑。然而，在新冠疫情期间，放射肿瘤学界现在已到了采用大分割放射治疗的重要时间节点。本综述的目的是基于前瞻性随机试验概述乳腺癌的大分割放射治疗，并讨论关于大分割放射治疗的特殊考量。
