对乳腺放射治疗的个性化方法:治疗精细化策略
Diana A Roth O'Brien1, Lior Z Braunstein1
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Clinical advances in hematology & oncology : H&O
|February 5, 2025
概括
乳腺癌的放射疗法降级,包括低分化和在低风险病例中省略治疗,在减少副作用的同时保持瘤结果. 这种个性化的方法改善了患者的生活质量.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 乳腺癌治疗方法 乳腺癌治疗方法
背景情况:
- 辅助放射治疗 (RT) 是乳腺癌手术后的标准,以减少局部复发.
- 了解乳腺癌生物学和治疗结果的进展推动了对缓解RT升级的兴趣.
- 降级旨在尽量减少治疗负担和副作用,而不会影响瘤控制.
研究的目的:
- 对乳腺癌中RT降级策略的现有证据和正在进行的试验进行审查.
- 探索针对各种乳腺癌亚型和阶段的个性化RT方法.
- 评估降级对治疗负担,副作用和瘤结局的影响.
主要方法:
- 审查临床试验数据和关于RT降级技术的出版文献.
- 对低分离,超低分离和加速部分乳房照射疗效的分析.
- 检查在选择低风险早期和局部晚期乳腺癌中省略RT的证据.
- 讨论以生物标志物为指导的RT降级和特定乳腺癌亚型的新兴数据.
主要成果:
- 低分离和超低分离显示了与传统RT相比的效果,用于全乳房照射,并且具有更好的方便性.
- 加速部分乳房照射在选定的患者中是有效的,强调了谨慎的患者选择.
- 在特定的低风险,早期阶段人群中,支持RT的省略,特别是患有激素受体阳性疾病的老年女性.
- 针对HER2阳性,三阴性和局部晚期乳腺癌的生物标志物引导降级和策略正在研究中.
结论:
- 包括改变分成和选择性遗漏在内的RT缓解策略可以维持瘤结果.
- 个性化RT方法提供了改善生活质量的潜力,并降低了治疗毒性.
- 目前正在进行的研究继续改进不同乳腺癌情景的缓解策略.
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