Emerging Role of Hypof ractionated Radiotherapy with Simultaneous Integrated Boost in Modern Radiotherapy of Breast Cancer

摘要

Summary Hypofractionated radiotherapy for breast cancer is becoming increasingly important. The scientific background of this development as well as the introduction of the simultaneous integrated boost to the primary tumor region in this context are discussed here. Current standard whole breast irradiation (WBI) in breast-conserving concepts consists of a total dose (TD) of 50 Gy delivered in 25 daily fractions over a period of approximately 35 days. Alternatively, 50.4 Gy are applied using a daily dose of 1.8 Gy. An additional boost to the primary tumor region at a TD of 12-16 Gy is indicated in the majority of patients, resulting in an overall treatment period of up to 47 days [1-4]. Impressive data of more than 10,000 women in 17 randomized trials with a 15-year follow-up confirm a risk reduction of ipsilateral breast recurrences by a factor of at least 3-4 [5]. This translates into a risk reduction of about 3% for breast cancer deaths in node-negative patients and about 8% in node-positive patients. Moreover, there is plenty of experience concerning treatment-related acute and late toxicity accompanied by excellent cosmetic results [1].