早期乳腺癌放射治疗进展

放射治疗在早期乳腺癌的综合治疗中具有重要地位。在早期浸润性乳腺癌乳房保留治疗已成熟的基础上，近年的临床研究着眼于对乳房保留治疗的标准模式的挑战，包括全乳照射后瘤床加量的意义，是否有低危复发患者可以接受单纯手术以及部分乳腺照射的可行性等。对于局部复发高危患者进行乳房切除术后胸壁和区域淋巴结的放射治疗可以降低2／3的局部和区域的复发率，但是目前仍然只有少数研究证实术后放疗提高了生存率，尤其关于中等复发危险的患者术后放疗是否有价值尚存在较多争议。本文将对上述进展和争议作一综述。

Advances in radiation therapy for early stage breast cancer

Radiation therapy plays an important role in the multidisciplinary treatment of early stage breast cancer. While breast conservative treatment has become an established strategy, recent clinical investigations focus mainly on the possibility of modification to the standard practice, including the significance of tumor bed boost after whole breast irradiation, the criteria for low-risk patients not to receive adjuvant radiotherapy after breast conservative surgery and the feasibility of partial breast irradiation. Post-mastectomy radiotherapy to the chest wall and regional lymph nodes in high-risk patients has been proved to reduce the local-regional recurrence by 2/3. However, only a few trials support the improvement of survival, and significant controversy exists concerning the role of post-mastectomy radiotherapy in intermediate -risk patients. Current review summarizes the advances and controversies stated above for the treatment of early stage breast cancer.