[Impact of radiotherapy modalities on local control and survival in adjuvant breast cancer treatment]

Cancer Radiother. 2009 Sep;13(5):434-45. doi: 10.1016/j.canrad.2009.01.006. Epub 2009 Mar 19.
[Article in French]

Abstract

Conventional radiotherapy (RT) in breast cancer treatment includes a total dose of 50Gy with a 16Gy-boost in a smaller volume. After mastectomy, radiotherapy of all node-positive patients seems to be applied whatever the positive node number. Modulation of RT technique uses the fraction dose, namely through accelerated hypofractionation regimen in a constant volume. A group of patient with a low risk of recurrence may benefit from this technique. In a smaller irradiated volume, accelerated hypofractionation still belongs to intensive clinical research evaluating intraoperative RT, brachytherapy, Mammosite, and external partial breast irradiation. Intensity-modulated radiotherapy decreases the risk of moist desquamation. The development of the gating offers greater protection of certain critical organs including lung, heart, and chest/ribs. Finally, predictive tests identifying patients at high risk of developing late effects led us to adapt RT technique to some of them and therefore increase long term therapeutic ratio.

MeSH terms

  • Apoptosis
  • Axilla
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • CD8-Positive T-Lymphocytes / radiation effects
  • Carcinoma, Ductal, Breast / mortality
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / radiotherapy*
  • Carcinoma, Ductal, Breast / surgery
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Lymphatic Irradiation / methods
  • Mastectomy
  • Radiation Tolerance
  • Radiotherapy, Adjuvant / methods
  • Radiotherapy, Adjuvant / mortality
  • Radiotherapy, Conformal / methods
  • Respiration
  • Tumor Burden / radiation effects