Early-stage breast cancer Irradiation: who, when, where and how long?

被引:0
作者
Matuschek, Christiane [1 ]
Budach, Wilfried [1 ]
机构
[1] Heinrich Heine Univ, Klin Strahlentherapie & Radioonkol, Med Fak, Moorenstr 5, D-40225 Dusseldorf, Germany
来源
ONKOLOGE | 2021年 / 27卷 / 12期
关键词
Breast-conserving therapy; Radiotherapy; adjuvant; Breast cancer; Moderate hypofractionation; Radiation oncology; TARGETED INTRAOPERATIVE RADIOTHERAPY; UK STANDARDIZATION; CONSERVING SURGERY; RADIATION-THERAPY; FOLLOW-UP; TRIAL; BOOST; HYPOFRACTIONATION; CHEMOTHERAPY; OUTCOMES;
D O I
10.1007/s00761-021-01057-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background In early-stage breast cancer, breast-conserving surgery is usually performed. This also includes an adjuvant radiotherapy, which for decades was administered daily over a period of 5-7 weeks. Whole-breast irradiation with or without a boost was standard practice. Objective An evidence-based review to determine who should be irradiated, when, where and for how long. Material and methods A systematic literature review of the relevant articles published in PubMed and in other databases between 2004 and 2021 was performed. Results After breast-conserving surgery, adjuvant radiotherapy of the breast results in a significantly reduced local recurrence rate. The current irradiation concept is moderately hypofractionated. In the case of very low recurrence risk and/or old age, partial breast irradiation or in selected subgroups ultra-hypofractionated irradiation schedules can be used. Otherwise, a boost can be administered to reduce the risk of local recurrence in higher risk patients. Conclusion Essentially, adjuvant radiotherapy after breast-conserving surgery is a well-studied technique with few side effects, which can reduce the risk of local recurrence by a factor of 3. Various concepts and techniques are available for individualized treatment. Overall, there is a trend towards de-escalation of radiotherapy in early-stage breast cancer.
引用
收藏
页码:1220 / 1227
页数:8
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