Adjuvant radiotherapy in the management of axillary node negative invasive breast cancer: A qualitative systematic review
A partir d'une revue systématique de la littérature publiée entre 1980 et 2012 (75 articles), cette étude identifie les indications et les recommandations associées à une radiothérapie adjuvante en combinaison avec une chirurgie conservatrice pour traiter un cancer du sein invasif de stade précoce sans métastase ganglionnaire axillaire
Purpose To actualize and to detail guidelines used in technical radiotherapy and indications for innovative radiation technologies in early axillary node negative breast cancer (BC). Methods Dosimetric and treatment planning studies, phase II and III trials, systematic reviews and retrospective studies were all searched (Medline® database). Their quality and clinical relevance were also checked against validated checklists. A level of evidence was associated for each result. Results A total of 75 references were included. Adjuvant BC radiotherapy (50 Gy/25 fractions/5 weeks followed by a tumor boost of 16 Gy/8 fractions) is still the standard of care. Overall treatment time could be shortened for patients who present with low local relapse risk BC by using either hypofractionated whole breast irradiation; or accelerated partial breast irradiation. BC IMRT is not used in current practice. Conclusion Our group aimed to provide guidelines for technical and clinical applications of innovative BC radiation technologies.
http://www.sciencedirect.com/science/article/pii/S104084281200193X 2012