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Strahlentherapie des Mammakarzinoms

Primär operables inklusive nichtinvasives Karzinom

Radiotherapy for breast cancer

Primary operable cancer including noninvasive carcinoma

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Der Onkologe Aims and scope

Zusammenfassung

Der Nutzen der Nachbestrahlung nach brusterhaltender Operation des Mammakarzinoms ist gut belegt. Man sieht nach den Ergebnissen der Metaanalyse der Early Breast Cancer Trialists Collaborative Group, basierend auf Untersuchungen an 7311 Patientinnen, eine deutliche Reduktion des Lokalrezidivrisikos verbunden mit einem Überlebensvorteil von ca. 5% nach 15 Jahren (p=0,005). Durch Strahlentherapie wird das Lokalrezidivrisiko etwa um den Faktor 3 gesenkt. Vier verhinderte Lokalrezidive verhindern einen Todesfall. Fast alle Brustkebspatientinnen benötigen nach brusterhaltender Operation eine Strahlenbehandlung. In der Regel wird diese gut vertragen. Als wesentliche Akutnebenwirkung sind das Erythem der Haut und ein geringes bis mäßiges Ödem der Brust zu nennen. Fibrosebedingte Formveränderungen der Brust als Spätnebenwirkung der Strahlentherapie sind durch den Einsatz moderner Bestrahlungstechniken seltener geworden. Dasselbe gilt für lebensbedrohliche Spätfolgen einer Strahlentherapie wie induzierte Zweittumoren und Herzschädigungen. Insbesondere Letztere können heute fast vollständig vermieden werden. Der folgende Beitrag versucht, die aktuellen Studien nach Subgruppen zu analysieren und evt. Subgruppen zu definieren, die von einer Strahlentherapie nicht profitieren.

Abstract

The benefit of adjuvant radiotherapy after breast-conserving therapy is well established. A significant reduction of the local recurrence rate according to the results of the Early Breast Cancer Trialists’ Collaborative Group has been sufficiently demonstrated. The overall survival rate is increased by about 5% after 15 years (p=0.005). Radiotherapy reduces the local recurrence rate by about a factor of 3. Four prevented local recurrences prevent one death. Almost all breast cancer patients need radiotherapy after breast-conserving surgery. In most cases the therapy is well tolerated. One of the most common acute side effects however is skin erythema and mild to moderate edema of the irradiated breast. Deformation of the breast as a late side effect induced by radiotherapy rarely occurs since the advent of modern radiation techniques. The same is valid for potentially life-threatening late effects of radiotherapy like secondary cancers or heart damage. The last-mentioned can be avoided with modern techniques. One objective of this article is to analyze current studies and identify subgroups of patients who do not benefit from radiotherapy.

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  1. Klinik und Poliklinik für Strahlentherapie und Radiologische Onkologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    C. Matuschek & W. Budach

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  1. C. Matuschek
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  2. W. Budach
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Correspondence to C. Matuschek.

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Matuschek, C., Budach, W. Strahlentherapie des Mammakarzinoms. Onkologe 14, 497–503 (2008). https://doi.org/10.1007/s00761-008-1356-7

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  • DOI: https://doi.org/10.1007/s00761-008-1356-7

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