乳腺癌保乳術后加速部分乳腺放射治療的臨床應用現狀_《華西醫學》

作者：

姜慶豐 , 譚榜憲

川北醫學院附屬醫院腫瘤放療科（四川南充，637000）;

關鍵詞：

乳腺腫瘤保乳術放射治療加速部分乳腺放射治療

DOI：

CNKI: 51-1356/R.20120214.1341.025

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

基于對大多數乳腺癌復發部位多位于原發灶附近的臨床觀察，一種相對于全乳腺放射治療（WBI）的照射區域更小、治療總時間更短而療效相當的新放射治療技術——加速部分乳腺放射治療（APBI）在臨床中得以運用。APBI技術放射治療總劑量為38.5 Gy，3.85 Gy/次，2次/d，且每2次間隔時間不＜6 h。WBI有長時間的臨床實踐依據肯定治療效果，而APBI長期臨床數據尚不完善，所以目前在選擇APBI技術時需謹慎。合理的患者納入標準、準確的照射靶區確定、長期的療效評價成為APBI目前的研究熱點。現對APBI最近的應用現狀進行綜述。

引用本文： 姜慶豐,譚榜憲. 乳腺癌保乳術后加速部分乳腺放射治療的臨床應用現狀. 華西醫學, 2012, 27(2): 304-308. doi: CNKI: 51-1356/R.20120214.1341.025 復制

1.	Radiat Oncol Biol Phys, 2011, 81(3): 788-794.
2.	孫燕, 右遠凱. 臨床腫瘤內科手冊[M]. 北京: 人民衛生出版社, 2008: 425.
3.	Sankaranarayanan R, Swaminathan R, Brenner H, et al. Cancer survival in Africa, Asia, and Central America: a population-based study[J]. Lancet Oncol, 2010, 11(2): 165-173.
4.	American Cancer Society. Cancer Facts & Figures 2008[M]. Atlanta: American Cancer Society, 2008: 11.
5.	Koukourakis G. Radiation therapy for early breast cancer[J]. Clin Transl Oncol, 2009, 11(9): 596-603.
6.	Goodwin A, Parker S, Ghersi D, et al. Post-operative radiotherapy for ductal carcinoma in situ of the breast[J]. Cochrane Database Syst Rev, 2009, (4): CD000563.
7.	Sanders ME, Scroggins T, Ampil FL, et al. Accelerated partial breast irradiation in early-stage breast cancer[J]. J Clin Oncol, 2007, 25(8): 996-1002.
8.	Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer[J]. N Engl J Med, 2002, 347(16): 1227-1232.
9.	Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials[J]. Lancet, 2005, 366(9503): 2087-2106.
10.	Vinh-Hung V, Verschraegen C. Breast-conserving surgery with or without radiotherapy: pooled-analysis for risks of ipsilateral breast tumor recurrence and mortality[J]. J Natl Cancer Inst, 2004, 96(2): 115-121.
11.	Koukourakis G. Radiation therapy for early breast cancer[J]. Clin Transl Oncol, 2009, 11(9): 596-603.
12.	Smith BD, Arthur DW, Buchholz TA, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO)[J]. Int J Radiat Oncol Biol Phys, 2009, 74(4): 987-1001.
13.	Polar C, van Limbergen E, Potter R, et al. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)[J]. Radiother Oncol, 2010, 94(3): 264-273.
14.	Offersen BV, Overgaard M, Kroman N, et al. Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: a systematic review[J]. Radiother Oncol, 2009, 90(1): 1-13.
15.	Weed DW, Yan D, Martinez AA, et al. The validity of surgical clips as a radiographic surrogate for the lumpectomy cavity in image-guided accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2004, 60(2): 484-492.
16.	Weed DW, Yan D, Martinez AA, et al. The validity of surgical clips as a radiographic surrogate for the lumpectomy cavity in image-guided accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2004, 60(2): 484-492.
17.	Bourgier C, Pichenot C, Verstraet R, et al. Early side effects of three-dimensional conformal external beam accelerated partial breast irradiation to a total dose of 40 Gy in one week (a phase Ⅱ trial)[J]. Int J Radiat Oncol Biol Phys, 2011, 81(5): 1228-1235.
18.	Jain AK, Vallow LA, Gale AA, et al. Does three-dimensional external beam partial breast irradiation spare lung tissue compared with standard whole breast irradiation? [J]. Int J Radiat Oncol Biol Phys, 2009, 75(1): 82-88.
19.	Livi L, Buonamici FB, Simontacchi G, et al. Accelerated partial breast irradiation with IMRT: new technical approach and interim analysis of acute toxicity in a phase Ⅲrandomized clinical trial[J]. Int J Radiat Oncol Biol Phys, 2010, 77(2): 509-515.
20.	Chen PY, Wallace M, Mitchell C, et al. Four-year efficacy, cosmesis,and toxicity using three-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 76(4): 991-997.
21.	Moran JM, Ben-David MA, Marsh RB, et al. Accelerated partial breast irradiation: what is dosimetric effect of advanced technologyapproaches?[J]. Int J Radiat Oncol Biol Phys, 2009, 75(1): 294-301.
22.	Zellars RC, Stearns V, Frassica D, et al. Feasibility trial of partial breast irradiation with concurrent dose-dense doxorubicin and cyclophosphamide in early-stage breast cancer[J]. J Clin Oncol, 2009, 27(17): 2816-2822.
23.	Wadasadawala T, Budrukkar A, Chopra S, et al. Quality of life after accelerated partial breast irradiation in early breast cancer: matched pair analysis with protracted whole breast radiotherapy[J]. Clin Oncol, 2009, 21(9): 668-675.
24.	Sher DJ, Wittenberg E, Suh WW, et al. Partial-breast irradiation versus whole-breast irradiation for early-stage breast cancer: a cost-effectiveness analysis[J]. Int J Radiat Oncol Biol Phys, 2009, 74(2): 440-446.
25.	Hepel JT, Tokita M, MacAusland SG, et al. Toxicity of three-dimensional conformal radiotherapy for accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5): 1290-1296.
26.	Jagsi R, Ben-David MA, Moran JM, et al. Unacceptable cosmesis in a protocol investigating intensity-modulated radiotherapy with active breathing control for accelerated partial-breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 76(1): 71-78.
27.	Shaitelman SF, Kim LH, Grills IS, et al. Predictors of long-term toxicity using three-dimensional conformal external beam radiotherapy to deliver accelerated partial breast irradiation[J]. Int J.
28.	Vicini F, Winter K, Wong J, et al. Initial efficacy results of RTOG 0319: three-dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for stage Ⅰ/Ⅱ breast carcinoma[J]. Int J Radiat Oncol Biol Phys, 2010, 77(4): 1120-1127.
29.	Recht A, Ancukiewicz M, Mohamed A. Lung dose-volume parameters and the risk of pneumonitis for patients treated with accelerated partial-breast irradiation using three-dimensional conformal radiotherapy[J]. J Clin Oncol, 2009, 27(24): 3887-3893.
30.	Valachis A, Mauri D, Polyzos NP, et al. Partial breast irradiation or whole breast radiotherapy for early breast cancer: a meta-analysis of randomized controlled trials[J]. Breast J, 2010, 16(3): 245-251.
31.	Antonucci JV, Wallace M, Goldstein NS, et al. Differences in patterns of failure in patients treated with accelerated partial breast irradiation versus whole-breast irradiation: a matched-pair analysis with 10-year follow-up[J]. Int J Radiat Oncol Biol Phys, 2009, 74(2): 447-452.
32.	Strnad V, Hildebrandt G, Pötter R, et al. Accelerated partial breast irradiation: 5-year results of the German-Austrian multicenter phase Ⅱ trial using interstitial multicatheter brachytherapy alone after breast-conserving surgery[J]. Int J Radiat Oncol Biol Phys, 2011, 80(1): 17-24.
33.	McHaffie DR, Patel RR, Adkison JB, et al. Outcomes after accelerated partial breast irradiation in patients with ASTRO consensus statement cautionary features[J]. Int J Radiat Oncol Biol Phys, 2011, 81(1): 46-51.
34.	李建彬, 范廷勇, 盧潔, 等. 乳腺癌保乳術后部分乳腺三維適形放療的臨床觀察[J]. 中華放射腫瘤學雜志, 2007, 16(6): 439-443.
35.	李鳳巖, 何振宇, 童琴, 等. 早期乳腺癌保乳術后部分乳腺三維適形加速外照射劑量學研究[J]. 中山大學學報, 2008, 29(4): 482-485.
36.	Li FY, He ZY, Xue M, et al. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients[J]. Chin Med J (Engl), 2011, 124(9): 1305-1309.
37.	He ZY, Tong Q, Wu SG, et al. A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus wholebreast irradiation in China[J/OL]. Breast Cancer Res Treat, [2011-10-28]. http://www.springerlink.com/content/qt2608p286328553/fulltext.pdf.

1. Radiat Oncol Biol Phys, 2011, 81(3): 788-794.
2. 　孫燕, 右遠凱. 臨床腫瘤內科手冊[M]. 北京: 人民衛生出版社, 2008: 425.
3. 　Sankaranarayanan R, Swaminathan R, Brenner H, et al. Cancer survival in Africa, Asia, and Central America: a population-based study[J]. Lancet Oncol, 2010, 11(2): 165-173.
4. 　American Cancer Society. Cancer Facts & Figures 2008[M]. Atlanta: American Cancer Society, 2008: 11.
5. 　Koukourakis G. Radiation therapy for early breast cancer[J]. Clin Transl Oncol, 2009, 11(9): 596-603.
6. 　Goodwin A, Parker S, Ghersi D, et al. Post-operative radiotherapy for ductal carcinoma in situ of the breast[J]. Cochrane Database Syst Rev, 2009, (4): CD000563.
7. 　Sanders ME, Scroggins T, Ampil FL, et al. Accelerated partial breast irradiation in early-stage breast cancer[J]. J Clin Oncol, 2007, 25(8): 996-1002.
8. 　Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer[J]. N Engl J Med, 2002, 347(16): 1227-1232.
9. 　Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials[J]. Lancet, 2005, 366(9503): 2087-2106.
10. 　Vinh-Hung V, Verschraegen C. Breast-conserving surgery with or without radiotherapy: pooled-analysis for risks of ipsilateral breast tumor recurrence and mortality[J]. J Natl Cancer Inst, 2004, 96(2): 115-121.
11. 　Koukourakis G. Radiation therapy for early breast cancer[J]. Clin Transl Oncol, 2009, 11(9): 596-603.
12. 　Smith BD, Arthur DW, Buchholz TA, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO)[J]. Int J Radiat Oncol Biol Phys, 2009, 74(4): 987-1001.
13. 　Polar C, van Limbergen E, Potter R, et al. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)[J]. Radiother Oncol, 2010, 94(3): 264-273.
14. 　Offersen BV, Overgaard M, Kroman N, et al. Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: a systematic review[J]. Radiother Oncol, 2009, 90(1): 1-13.
15. 　Weed DW, Yan D, Martinez AA, et al. The validity of surgical clips as a radiographic surrogate for the lumpectomy cavity in image-guided accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2004, 60(2): 484-492.
16. 　Weed DW, Yan D, Martinez AA, et al. The validity of surgical clips as a radiographic surrogate for the lumpectomy cavity in image-guided accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2004, 60(2): 484-492.
17. 　Bourgier C, Pichenot C, Verstraet R, et al. Early side effects of three-dimensional conformal external beam accelerated partial breast irradiation to a total dose of 40 Gy in one week (a phase Ⅱ trial)[J]. Int J Radiat Oncol Biol Phys, 2011, 81(5): 1228-1235.
18. 　Jain AK, Vallow LA, Gale AA, et al. Does three-dimensional external beam partial breast irradiation spare lung tissue compared with standard whole breast irradiation? [J]. Int J Radiat Oncol Biol Phys, 2009, 75(1): 82-88.
19. 　Livi L, Buonamici FB, Simontacchi G, et al. Accelerated partial breast irradiation with IMRT: new technical approach and interim analysis of acute toxicity in a phase Ⅲrandomized clinical trial[J]. Int J Radiat Oncol Biol Phys, 2010, 77(2): 509-515.
20. 　Chen PY, Wallace M, Mitchell C, et al. Four-year efficacy, cosmesis,and toxicity using three-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 76(4): 991-997.
21. 　Moran JM, Ben-David MA, Marsh RB, et al. Accelerated partial breast irradiation: what is dosimetric effect of advanced technologyapproaches?[J]. Int J Radiat Oncol Biol Phys, 2009, 75(1): 294-301.
22. 　Zellars RC, Stearns V, Frassica D, et al. Feasibility trial of partial breast irradiation with concurrent dose-dense doxorubicin and cyclophosphamide in early-stage breast cancer[J]. J Clin Oncol, 2009, 27(17): 2816-2822.
23. 　Wadasadawala T, Budrukkar A, Chopra S, et al. Quality of life after accelerated partial breast irradiation in early breast cancer: matched pair analysis with protracted whole breast radiotherapy[J]. Clin Oncol, 2009, 21(9): 668-675.
24. 　Sher DJ, Wittenberg E, Suh WW, et al. Partial-breast irradiation versus whole-breast irradiation for early-stage breast cancer: a cost-effectiveness analysis[J]. Int J Radiat Oncol Biol Phys, 2009, 74(2): 440-446.
25. 　Hepel JT, Tokita M, MacAusland SG, et al. Toxicity of three-dimensional conformal radiotherapy for accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5): 1290-1296.
26. 　Jagsi R, Ben-David MA, Moran JM, et al. Unacceptable cosmesis in a protocol investigating intensity-modulated radiotherapy with active breathing control for accelerated partial-breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 76(1): 71-78.
27. 　Shaitelman SF, Kim LH, Grills IS, et al. Predictors of long-term toxicity using three-dimensional conformal external beam radiotherapy to deliver accelerated partial breast irradiation[J]. Int J.
28. 　Vicini F, Winter K, Wong J, et al. Initial efficacy results of RTOG 0319: three-dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for stage Ⅰ/Ⅱ breast carcinoma[J]. Int J Radiat Oncol Biol Phys, 2010, 77(4): 1120-1127.
29. 　Recht A, Ancukiewicz M, Mohamed A. Lung dose-volume parameters and the risk of pneumonitis for patients treated with accelerated partial-breast irradiation using three-dimensional conformal radiotherapy[J]. J Clin Oncol, 2009, 27(24): 3887-3893.
30. 　Valachis A, Mauri D, Polyzos NP, et al. Partial breast irradiation or whole breast radiotherapy for early breast cancer: a meta-analysis of randomized controlled trials[J]. Breast J, 2010, 16(3): 245-251.
31. 　Antonucci JV, Wallace M, Goldstein NS, et al. Differences in patterns of failure in patients treated with accelerated partial breast irradiation versus whole-breast irradiation: a matched-pair analysis with 10-year follow-up[J]. Int J Radiat Oncol Biol Phys, 2009, 74(2): 447-452.
32. 　Strnad V, Hildebrandt G, Pötter R, et al. Accelerated partial breast irradiation: 5-year results of the German-Austrian multicenter phase Ⅱ trial using interstitial multicatheter brachytherapy alone after breast-conserving surgery[J]. Int J Radiat Oncol Biol Phys, 2011, 80(1): 17-24.
33. 　McHaffie DR, Patel RR, Adkison JB, et al. Outcomes after accelerated partial breast irradiation in patients with ASTRO consensus statement cautionary features[J]. Int J Radiat Oncol Biol Phys, 2011, 81(1): 46-51.
34. 　李建彬, 范廷勇, 盧潔, 等. 乳腺癌保乳術后部分乳腺三維適形放療的臨床觀察[J]. 中華放射腫瘤學雜志, 2007, 16(6): 439-443.
35. 　李鳳巖, 何振宇, 童琴, 等. 早期乳腺癌保乳術后部分乳腺三維適形加速外照射劑量學研究[J]. 中山大學學報, 2008, 29(4): 482-485.
36. 　Li FY, He ZY, Xue M, et al. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients[J]. Chin Med J (Engl), 2011, 124(9): 1305-1309.
37. 　He ZY, Tong Q, Wu SG, et al. A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus wholebreast irradiation in China[J/OL]. Breast Cancer Res Treat, [2011-10-28]. http://www.springerlink.com/content/qt2608p286328553/fulltext.pdf.

《華西醫學》

乳腺癌保乳術后加速部分乳腺放射治療的臨床應用現狀

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《華西醫學》

乳腺癌保乳術后加速部分乳腺放射治療的臨床應用現狀

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料