Progress and controversies: Radiation therapy for invasive breast cancer

被引:52
作者
Jagsi, Reshma [1 ,2 ]
机构
[1] Univ Michigan, Dept Radiat Oncol, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Ctr Bioeth & Social Sci Med, Ann Arbor, MI 48109 USA
基金
美国国家卫生研究院;
关键词
hypofractionation; breast cancer; postmastectomy radiation; intensity-modulated radiotherapy; breast-conserving therapy; radiation therapy; partial breast irradiation; LOW-DOSE-RATE; TARGETED INTRAOPERATIVE RADIOTHERAPY; INTENSITY-MODULATED RADIOTHERAPY; LUMPECTOMY PLUS TAMOXIFEN; SURGICAL ADJUVANT BREAST; INTERSTITIAL IMPLANT BRACHYTHERAPY; LOCOREGIONAL RECURRENCE RISK; INITIAL CLINICAL-EXPERIENCE; EXTERNAL-BEAM RADIOTHERAPY; EXCISION 12-YEAR OUTCOMES;
D O I
10.3322/caac.21209
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Radiation therapy is a critical component of the multidisciplinary management of invasive breast cancer. In appropriately selected patients, radiation not only improves local control, sparing patients the morbidity and distress of local recurrence, but it also improves survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. In recent years, considerable progress has been made toward improving our ability to select patients most likely to benefit from radiotherapy and to administer treatment in ways that maximize clinical benefit while minimizing toxicity and burden. This article reviews the role of radiation therapy in invasive breast cancer management, both after breast-conserving surgery and after mastectomy. It focuses particularly on emerging evidence that helps to define the clinical situations in which radiotherapy is indicated, the appropriate targets of treatment, and optimal approaches for minimizing both the toxicity and the burden of treatment, all in the context of the evolving surgical and systemic management of this common disease. It includes a discussion of new approaches in breast cancer radiotherapy, including hypofractionation and intensity modulation, as well as a discussion of promising avenues for future research. CA Cancer J Clin 2014;64:135-152. ((c)) 2013 American Cancer Society.
引用
收藏
页码:135 / 152
页数:18
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