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Fifty years of progress in radiation therapy for breast cancer.
- Source :
-
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting [Am Soc Clin Oncol Educ Book] 2014, pp. 21-5. - Publication Year :
- 2014
-
Abstract
- Fifty years ago, radiation therapy (RT) was only used after mastectomy in patients with high-risk disease. The equipment, treatment planning, and treatment delivery were rudimentary compared to what is available today. In retrospect, the deleterious effects of the RT back then negated its benefits. The strategy of combining lesser surgery with RT (and adjuvant systemic therapy) has been successfully employed in breast-conserving therapy (BCT) and in avoiding axillary lymph node dissection in patients with 1 or 2 involved sentinel nodes. Local recurrence rates at 10 years following BCT are now similar to those following mastectomy. RT after breast-conserving surgery and after mastectomy has been demonstrated to not only decrease local-regional recurrence but also decrease distant metastases and improve long-term survival. The development of effective adjuvant systemic therapy has made RT not only more effective but also arguably more important. If systemic therapy is effective at addressing micro-metastatic disease, then obtaining local tumor control becomes even more important. Moderately hypofractionated RT (2.66 Gy per day) is just as safe and effective as conventional fractionation shortening BCT from 6 weeks to 3-4 weeks. Treatment is now given with multiple-energy linear accelerators, CT-based simulation, 3-dimensional beam modulation for much greater dose homogeneity, on-board imaging for greater daily accuracy, and various techniques to reduce cardiac dose.
- Subjects :
- Animals
Breast Neoplasms mortality
Breast Neoplasms pathology
Disease Progression
Disease-Free Survival
Female
History, 20th Century
History, 21st Century
Humans
Mastectomy trends
Medical Oncology history
Neoplasm Recurrence, Local
Radiation Dosage
Radiotherapy, Adjuvant
Radiotherapy, Computer-Assisted adverse effects
Radiotherapy, Computer-Assisted history
Risk Factors
Time Factors
Treatment Outcome
Breast Neoplasms radiotherapy
Medical Oncology trends
Radiotherapy, Computer-Assisted trends
Subjects
Details
- Language :
- English
- ISSN :
- 1548-8756
- Database :
- MEDLINE
- Journal :
- American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
- Publication Type :
- Academic Journal
- Accession number :
- 24857056
- Full Text :
- https://doi.org/10.14694/EdBook_AM.2014.34.21