Onkologische Welt 2012; 03(05): 219-223
DOI: 10.1055/s-0038-1630244
Radio-Onkologie
Schattauer GmbH

Partialbrustbestrahlung nach Mammakarzinom

Intra- und perioperative Bestrahlungsmöglichkeiten unter besonderer Berücksichtigung des INTRABEAM-SystemsAccelerated partial breast irradiation in breast conserving therapyIntra- and perioperative brachytherapy with focus on the INTRABEAM system
U. Köppen
1   Klinik für Strahlentherapie und Radioonkologie, Katharinenhospital - Klinikum Stuttgart (ärztlicher Direktor: Prof. Dr. Marc Münter)
› Author Affiliations
Further Information

Publication History

Publication Date:
31 January 2018 (online)

Zusammenfassung

Radioonkologischer Standard im Rahmen der Brusterhaltenden Therapie ist nach wie vor die postoperative Ganzbrustbestrahlung mit zusätzlicher Aufsättigung der ehemaligen Tumorregion. Zahlreiche Bestrahlungstechniken wurden mittlerweile entwickelt, um den strahlentherapeutischen Boost der ursprünglichen Tumorlokalisation in den operativen Eingriff zu integrieren oder ihn ihm unmittelbar anzuschließen. Neben dem INTRABEAM System werden weitere Modalitäten zur alleinigen Radiatio des Tumorbetts bzw. in Kombination mit Ganzbrustbestrahlung dargestellt.

Summary

Standard breast conserving surgery routinely entails adjuvant whole breast irradiation plus a boost to the original tumour site. A wide variety of techniques has been developed to integrate the boost into the operation or add it as a short radiation procedure to the initial therapy. This survey focuses on the INTRABEAM system and other modalities aimed at sterilizing the tumour cavity with and without additional irradiation of the whole breast.

 
  • Literatur

  • 1 Fisher B. et al. Twenty-year follow-up of a randomised trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002; 347: 1233-1241.
  • 2 Veronesi U. et al. Twenty-year follow-up of a rando- mizsed study comparing breast conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002; 347: 1227-1232.
  • 3 Bartelink H. et al. Impact of higher radiation dose on local control and survival in breast-conserving therapy for early breast cancer: 10-year results of the randomized boost versus no boost EORTC 2281-10882 trial. J Clin Oncol 2007; 25: 3259-3265.
  • 4 Deutsche Krebsgesellschaft e.V. (Hrsg.) Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. 1. Aktualisierung 2008; Zuckschwerdt: München; ferner: Langversion 3.0, Aktualisierung 2012.
  • 5 Wenz F.. Intraoperative Strahlentherapie, 169-173 in: Kreienberg, R. et al. Mammakarzinom Interdisziplinär. 4. Aufl. 2010; Springer: Berlin/Heidelberg.
  • 6 Hepel JT, Wazer DE.. A comparison of brachyther- apy techniques for partial breast irradiation. Brachytherapy 2012; 11: 163-175.
  • 7 Lewin AA. et al. Accelerated partial breast irradiation is safe and effective using intensity-modulated radiation therapy in selected early-stage breast cancer. Int J Rad Oncol Biol Phys 2012; 82: 2104-2110.
  • 8 Wallace M. et al. Phase I/II study evaluating early tolerance in breast cancer patients undergoing accelerated partial breast irradiation treated with the mammosite ballon breast brachytherapy catheter using a 2-day dose schedule. Int J Rad Oncol Biol Phys 2010; 77: 531-536.
  • 9 Strnad V, Pötter R, Kovács G.. Praktisches Handbuch der Brachytherapie. 2. Aufl. 2010; Uni-Med: Bremen.
  • 10 Smith BD. et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Rad Oncol Biol Phys 2009; 74: 987-1001.
  • 11 Polgàr C. et al. Patient selection for accelerated partial breat irradiation (APBI) after breast-conserving surgery: recommendations of the Groupe Euro- péen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009). Radiother Oncol 2010; 94: 264-273.
  • 12 Leonardi MC.. How do the ASTRO consensus statement guidelines for the application of accelerated partial breast irradiation fit intraoperative radiotherapy? A retrospectiv analysis of patients treated at the European Institute of Oncology. Int J Rad Oncol Biol Phys 2012; 83: 806-813.
  • 13 Veronesi U. et al. Intraoperative radiotherapy during breast conserving surgery: a study on 1822 cases treated with electrons. Breast Cancer Res Treat 2010; 124: 141-151.
  • 14 Maluta S. et al. Accelerated partial breast irradiation using only intraoperative electron radiation therapy in early stage breast cancer. Int J Rad Oncol Biol Phys. 2012 Apr 27 [Epub ahead of print].
  • 15 Zurrida S.. Accelerated partial breat irradiation in early breat cancer: focus on intraoperative treatment with electrons (ELIOT). Womens Health 2012; 8: 89-98.
  • 16 Vaidya JS. et al. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet 2010; 376: 91-102.
  • 17 Sautter-Bihl M-L. et al. Intraoperative radiotherapy as accelerated partial breast irradiation for early breast cancer. Strahlenth Onkol 2010; 186: 651-657.
  • 18 Wenz F, Sütterlin M.. TARGIT E-Studienprotokoll, Stand 03.12.2010, Version 2.7. Klinik für Strahlentherapie und Radioonkologie und Universitätsfrauenklinik, Universitätsmedizin Mannheim.
  • 19 Reitsamer R. et al. Intraoperative radiotherapy for early breast cancer. Lancet 2010; 376 1141; author reply 1143-1144.
  • 20 Smith BD. et al. Intraoperative radiotherapy for early breast cancer. Lancet 2010; 376 1141; author reply 1143-1144.
  • 21 Haviland JS. et al. Intraoperative radiotherapy for early breast cancer. Lancet 2010; 376 1142; author reply 1143-1144.
  • 22 Cameron D. et al. Intraoperative radiotherapy for early breast cancer. Lancet 2010; 376 1142; author reply 1143-1144.
  • 23 Azria D. et al. Partial breast irradiation: new standard for selected patients. Lancet 2010; 376: 71-72.
  • 24 Bar Ad V. Accelerated partial breast irradiation - pros and cons. Rev Recent Clin Trials 2011; 6: 1-6.
  • 25 Wenz F, Kraus-Tiefenbacher U.. Intraoperative radiotherapy for breast cancer. 2011 Uni-Med: Bremen.
  • 26 Khan AJ. et al. Ultrashort courses of adjuvant breast radiotherapy: wave of the future or a fool’s errand?. Cancer 2012; 118: 1962-1970.
  • 27 Keshtgar MRS. et al. Targeted intraoperative radiotherapy for breast cancer in patients in whom external beam radiation is not possible. Int J Rad Oncol Biol Phys 2011; 80: 31-38.
  • 28 Smith GL. et al. Brachytherapy for accelerated partial-breast irradiation: a rapidly emerging technology in breast cancer care. J Clin Oncol 2011; 29: 157-165.
  • 29 Ferraro DJ. et al. Comparison of accelerated partial breast irradiation via multicatheter interstitial bra- chytherapy versus whole breast irradiation. Radiat Oncol 2012; 7: 53.
  • 30 Shah C.. Comparison of survival and regional failure between accelerated partial breast irradiation and whole breast irradiation. Brachytherapy 2012; 11: 311-315.