文献詳細
特集 知っておきたい 乳がん診療のエッセンス
治療編
文献概要
【ポイント】
◆早期乳がんは乳房部分切除術(乳房温存手術)後の放射線療法として,通常照射(50 Gy/25回)と短期照射(42.56 Gy/16回)があり,部分照射も検討されている.
◆進行乳がんは乳房切除術後に,胸壁への追加照射および領域リンパ節照射を組み合わせて行う.
◆放射線療法後の有害事象は,皮膚障害・肺障害・左側の場合の心臓への影響などがある.
◆早期乳がんは乳房部分切除術(乳房温存手術)後の放射線療法として,通常照射(50 Gy/25回)と短期照射(42.56 Gy/16回)があり,部分照射も検討されている.
◆進行乳がんは乳房切除術後に,胸壁への追加照射および領域リンパ節照射を組み合わせて行う.
◆放射線療法後の有害事象は,皮膚障害・肺障害・左側の場合の心臓への影響などがある.
参考文献
1)日本乳癌学会(編):科学的根拠に基づく 乳癌診療ガイドライン1 治療編 2015年版,第3版.金原出版,2015
2)Sonoo H, Noguchi S;Academic Committee of the Japanese Breast Cnacer Society:Results of questionnaire survey on breast cancer surgery in Japan 2004-2006. Breast Cancer 15:3-4, 2008
3)NCCN Clinical Practice Guidelines in Oncology. Breast Cancer, 2015
4)Chan EK, Woods R, Virani S:Long-term mortality from cardiac causes after adjuvant hypofractionated vs. conventional radiotherapy for localized left-sided breast cancer. Radiother Oncol 114:73-78, 2015
5)Whelan T, MacKenzie R, Julian J, et al:Randomized trial of breast irradiation schedules after lumpectomy for women with lymph node-negative breast cancer. J Natl Cancer Inst 92:1143-1150, 2002
6)唐澤久美子:乳房照射法と乳房照射をめぐる諸問題.癌の臨46:657-664,2000
7)Fisher ER, Anderson S, Tan-Chiu E, et al:Fifteen-year prognostic discriminants for invasive breast carcinoma:National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer 91:1679-1687, 2001
8)Njeh CF, Saunders MW, Langton CM:Accelerated Partial Breast Irradiation(APBI):A review of available techniques. Radiat Oncol 5:90, 2010
9)Vicini F, Shah C, Ben Wilkinson J, et al:Should ductal carcinoma-in-situ(DCIS)be removed from the ASTRO consensus panel cautionary group for off-protocol use of accelerated partial breast irradiation(APBI)? A pooled analysis of outcomes for 300 patients with DCIS treated with APBI. Ann Surg Oncol 20:1275-1281, 2013
10)Fisher B, Anderson S, Bryant J, et al:Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233-1241, 2002
11)Solin LJ, Fourquet A, Vicini FA, et al:Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation:long-term outcome and prognostic significant of patient age and margin status. Int J Radiat Oncol Biol Phys 50:991-1002, 2001
12)Kestin LL, Goldstein NS, Martinez AA, et al:Mammographically detected ductal carcinoma in situ treated with conservative surgery with or without radiation therapy:patterns of failure and 10-year results. Ann Surg 231:235-245, 2000
13)Shikama N, Sekiguchi K, Nakamura N, et al:Final results from a multicenter prospective study(JROSG 05-5)on postoperative radiotherapy for patients with ductal carcinoma in situ with an involved surgical margin or close margin widths of 1 mm or less. J Radiat Res 56:830-834, 2015
14)Donker M, van Tienhoven G, Straver ME, et al:Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer(EORTC 10981-22023 AMAROS):a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15:1303-1310, 2014
15)EBCTCG(Early Breast Cancer Trialist's Collaborative Group), McGale P, Taylor C, Correa C, et al:Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality:meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 383:2127-2135, 2014
16)Matsumura R, Oguchi M, Fujikane T, et al:Influence of lymphatic invasion on locoregional recurrence following mastectomy:indication for postmastectomy radiotherapy for breast cancer patients with one to three positive nodes. Int J Radiat Oncol Biol Phys 83:845-852, 2012
17)Loblaw DA, Laperriere NJ:Emergency treatment of malignant extradural spinal cord compression:an evidence-based guideline. J Clin Oncol 16:1613-1624, 1998
18)関根 広,小林雅夫,菅屋潤壹:電離放射線の発汗機能に及ぼす影響.発汗学9:2-5,2002
19)淡河恵津世:放射線皮膚炎に対するマネージメント.園尾博司(監),福田 護,池田 正,佐伯俊昭,他(編);これからの乳癌診療2009-2010.金原出版,2009,pp 136-141
20)Meric F, Buchholz TA, Miza NQ, et al:Long-term complication associated with breast conservation surgery and radiotherapy. Ann Surg Oncol 9:543-549, 2002
21)Allen AM, Prosnitz RG, Ten Haken RK, et al:Body mass index predicts the incidence of radiation pneumonitis in breast cancer patients. Cancer J 11:390-398, 2005
22)Lind PA, Wennberg B, Gagliardi G, et al:ROC curves and evaluation of radiation-induced pulmonary toxicity in breast cancer. Int J Radit Oncol Biol Phys 64:765-770, 2006
23)Boyages J, Bosch C, Langlands AO, et al:Breast conservation:long-team Australian data. Int J Radit Oncol Biol Phys 24:253-260, 1992
24)Dorr W, Bertmann S, Hermann T:Radiation induced lung reactions in breast cancer therapy. Modulating factors and consequential effects. Strahlenther Onkol 181:567-573, 2005
25)Yu TK, Whitman GJ, Thames HS, et al:Clinically relevant pneumonitis after sequential paclitaxel-based chemotherapy and radiotherapy in breast cancer patients. J Natl Cncer Inst 96:1676-1681, 2004
26)Ogo E, Komaki R, Fujimoto K, et al:A survey of radiaion-induced bronchiolitis obliterance organizing pneumonia syndrome after breast-conserving therapy in Japan. Int J Radiat Oncol Phys 71:123-131, 2007
27)Ogo E, Komaki R, Abe T, et al:The clinical characteristics and non-steroidal treatment for radiation-induced bronchiolitis obliterans organizing pneumonia syndrome after breast-conserving therapy. Radiother Oncol 97:95-100, 2010
28)淡河恵津世,中村和正,楠原和朗,他:乳房温存術後放射線治療中および直後における肺障害についての検討.臨放56:113-120,2011
29)Cuzick J, Stewart H, Rutgvist L, et al:Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 12:447-453, 1994
30)Giordano SH, Kuo TF, Freeman JL, et al:Risk of cardiac death after adjuvant radiotherapy for breast cancer. J Natl Cancer Inst 97:419-424, 2005
31)Lohr F, Rl-Haddad M, Dobler B, et al:Potential effect of robust and simple IMRT approach for left-sided breast cancer on cardiac mortality. Int J Radiat Oncol Biol Phys 74:73-80, 2009
32)Coon AB, Dickler A, Kirk MC, et al:Tomotherapy and multifield intensity-modulated radiotherapy planning reduce cardiac doses in left-sided breast cancer patients with unfavorable cardiac anatomy. Int J Radiat Oncol Biol Phys 78:104-110, 2010
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