乳腺癌放射治疗的既有领域与新视野。
Established and new horizons in radiotherapy for breast cancer.
作者信息
Wu Trudy C, McCloskey Susan A
机构信息
Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Radiation Oncology, University of California Los Angeles, 200 Medical Plaza Driveway, Suite #B265, Los Angeles, CA 90095, USA.
出版信息
Ther Adv Med Oncol. 2023 Mar 18;15:17588359231161415. doi: 10.1177/17588359231161415. eCollection 2023.
Modern advances in diagnostics, surgery, systemic therapies, and radiotherapy (RT) have drastically revolutionized treatment strategies for breast cancer. This review outlines current and evolving treatment paradigms for RT in the breast-conserving therapy and post-mastectomy setting. In early-stage breast cancer, there is active investigation in expanding eligibility for omission of RT in women with more biologically favorable tumors and growing options to effectively irradiate less breast tissue and shorten RT treatment courses. For locally advanced breast cancer, we discuss several patient cohorts in which the necessity of post-mastectomy RT (PMRT) is commonly debated. Ongoing efforts to better refine indications for PMRT and evaluate the feasibility of hypofractionated PMRT are being studied. Metastasis-directed therapy with ablative RT is an emerging topic of interest in many cancers, including its role and impact in oligometastatic breast cancer. In this review, we will discuss the rationale for current standard of care and address in greater detail the aforementioned concepts.
诊断、外科手术、全身治疗及放射治疗（RT）方面的现代进展彻底变革了乳腺癌的治疗策略。本综述概述了保乳治疗和乳房切除术后放疗中RT的当前及不断演变的治疗模式。在早期乳腺癌中，对于生物学行为更有利的肿瘤患者，正在积极研究扩大省略放疗的适用范围，并且有效照射更少乳腺组织及缩短放疗疗程的选择也越来越多。对于局部晚期乳腺癌，我们讨论了几个经常对乳房切除术后放疗（PMRT）的必要性存在争议的患者群体。目前正在努力更好地完善PMRT的适应证，并评估大分割PMRT的可行性。采用消融性放疗的转移灶定向治疗是包括其在寡转移乳腺癌中的作用和影响在内的许多癌症中一个新兴的研究热点。在本综述中，我们将讨论当前护理标准的理论依据，并更详细地阐述上述概念。
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