Indikationen zur Strahlentherapie beim lokal rezidivierten Mammakarzinom

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• 作者：U. Küchenmeister (1)
  T. Kuhnt (1)
  H. Knauerhase (1)
  G. Hildebrandt (1)
  
• 关键词：Mammakarzinom ; Lokales Rezidiv ; Rebestrahlung ; Interstitielle Brachytherapie ; Perkutane Radiotherapie ; Breast cancer ; Local recurrence ; Re ; irradiation ; Interstitial brachytherapy ; Percutaneous radiotherapy
• 刊名：Der Onkologe
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：19
• 期：6
• 页码：481-486
• 全文大小：458KB
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• 作者单位：U. Küchenmeister (1)
  T. Kuhnt (1)
  H. Knauerhase (1)
  G. Hildebrandt (1)
  
  1. Klinik und Poliklinik für Strahlentherapie, Universit?tsmedizin Rostock, Südring 75, 18059, Rostock, Deutschland
  
• ISSN：1433-0415

文摘

Background Radiotherapy is an important option in the treatment of locally recurrent breast cancer. In contrast to the first-line therapy of breast cancer, randomized trials on locally recurrent disease are rare. Aim The goal of this paper is to describe the current indications and radiotherapy options for locally recurrent breast cancer. Methods After performing a selective literature review, clinical trial data were compared with our own results. Results For isolated in-breast tumor recurrence after primary breast conserving surgery (BCS), salvage mastectomy is standard therapy. However, in individual cases, re-BCS is also a possible option. After re-BCS, partial breast radiation can result in improved local control. However, randomized studies comparing this option with the results obtained after salvage mastectomy are lacking. Complete surgical removal is the first treatment option for chest wall recurrence. If during primary treatment no irradiation was applied, then extended field irradiation of the whole chest wall is indicated. In cases with high risk of further relapse or with inoperable recurrence, re-irradiation is possible. A combination with hyperthermia or chemotherapy can be used for radiation sensitization. Conclusion Results of second BCS with additional partial breast irradiation are promising. However, larger randomized studies are required. In the treatment of a chest wall recurrence, irradiation can improve local control. Re-irradiation is possible, but must always be made based on the individual case.