[Normofractionated breast irradiation in breast cancer. Indications and benefits].
Whole-breast normofractionated irradiation following breast-conserving surgery is the reference treatment. It delivers a dose of 50Gy in 25 fractions of 2Gy to the reference point, and, in some patients, an additional dose of 16Gy in 8 fractions of 2Gy in the tumor bed. Long-term results and toxicity of this irradiation scheme was prospectively evaluated in several randomised trials and meta-analyses, in invasive cancers as well as in ductal carcinoma in situ. The average 10-year rate of in breast recurrences was 6 % in these trials, with limited cardiac and pulmonary toxicity and limited rate of severe fibrosis. Identification of risk factors of recurrences may help to design new irradiation schemes adapted to tumor biology. The new irradiation schemes must be rigorously evaluated in the long-term in the frame of prospective clinical trials, in order to validate them as new standards of treatment.
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France. Electronic address: alain.fourquet@curie.fr.
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Fourquet
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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Krhili
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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Campana
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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Chilles
Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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Kirova
D000071960:Breast Carcinoma In Situ / Q000532:radiotherapy / Q000601:surgery; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D008168:Lung / Q000473:pathology / Q000528:radiation effects; D015412:Mastectomy, Segmental; D009206:Myocardium / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D058958:Organs at Risk; D018714:Radiotherapy, Adjuvant
Breast cancer; Breast-conserving treatment; Cancer du sein; Fractionation; Fractionnement; Radiotherapy; Radiothérapie; Traitement conservateur