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大分割全乳及部分乳腺照射:巴西放射治疗学会(SBRT)共识

Hypofractionated whole and partial breast irradiation: Brazilian Society of Radiotherapy (SBRT) consensus.

作者信息

Freitas Nilceana Maya Aires, Rosa Arthur Accioly, Castilho Marcus Simoes, Hanna Samir Abdallah, Campos Conceicao, de Andrade Carvalho Heloisa, Gondim Guilherme Rocha Melo, da Rocha Zanuncio Pedro Henrique, Fernandez Claudia Regina Scaramello Hadlich Willis, De Almeida Junior Wilson José, Borges Allisson Bruno Barcelos, Obst Fernando Mariano, Paiva Jean Teixeira, Faroni Lilian Dantonino, Campana André, de Sousa Cecília Félix Penido Mendes, Freitas-Junior Ruffo, Mattar Andre, de Resende Cristiano Augusto Andrade, Leite Rodrigo, Marta Gustavo Nader

机构信息

Serviço de Radioterapia do Hospital de Câncer Araújo Jorge, Instituto de Mastologia e Oncologia (IMO) e Oncoclínicas em Goiânia, Goiânia, Brazil.

Hospital Santa Izabel, Oncoclinicas Salvador, Salvador, Brazil.

出版信息

Rep Pract Oncol Radiother. 2025 Jun 7;30(2):236-245. doi: 10.5603/rpor.105862. eCollection 2025.

Abstract

BACKGROUND

Breast cancer is the most common cancer in women worldwide, with 73,610 new cases expected annually in Brazil between 2023 and 2025. Post-operative radiation therapy (PORT) is a critical component of treatment, and recent advances have allowed for shorter treatment times that can help overcome shortages in low- and middle-income countries. The Brazilian Society of Radiotherapy (SBRT) updated its consensus on hypofractionated whole-breast radiotherapy and included recommendations for partial breast irradiation.

MATERIALS AND METHODS

The SBRT convened a national panel of experts to develop updated recommendations. Using a modified Delphi method, the panel reached a consensus through structured rounds of voting. Recommendations were categorized based on the strength of available evidence.

RESULTS

The consensus supports hypofractionation, which offers shorter, cost-effective treatment schedules, and partial breast irradiation (PBI), which targets high-risk areas while sparing healthy tissue. Despite high-quality evidence, adopting these techniques has been inconsistent. The panel's recommendations provide evidence-based guidance to clinicians, tailored to the Brazilian context, emphasizing safety and efficacy.

CONCLUSION

The updated SBRT consensus presents hypofractionation and PBI as practical alternatives to conventional radiation therapy, offering improved access and reduced costs. These recommendations aim to guide clinicians in adopting these approaches and help address barriers to access.

摘要

背景

乳腺癌是全球女性中最常见的癌症,预计2023年至2025年期间巴西每年有73610例新发病例。术后放射治疗(PORT)是治疗的关键组成部分,最近的进展使得治疗时间缩短,这有助于克服低收入和中等收入国家的短缺问题。巴西放射治疗协会(SBRT)更新了其关于大分割全乳放疗的共识,并纳入了部分乳腺照射的建议。

材料与方法

SBRT召集了一个全国专家小组来制定更新后的建议。该小组采用改良的德尔菲法,通过结构化的投票轮次达成共识。建议根据现有证据的强度进行分类。

结果

该共识支持大分割放疗,其提供了更短、更具成本效益的治疗方案,以及部分乳腺照射(PBI),后者针对高危区域,同时保护健康组织。尽管有高质量的证据,但这些技术的采用并不一致。该小组的建议为临床医生提供了基于证据的指导,根据巴西的情况进行了调整,强调了安全性和有效性。

结论

更新后的SBRT共识提出大分割放疗和PBI是传统放疗的实用替代方案,可改善可及性并降低成本。这些建议旨在指导临床医生采用这些方法,并帮助解决可及性障碍。

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