Boost Radiotherapy for the Treatment of Ductal Carcinoma In Situ Remains Controversial

摘要: Over the past 40 years, technological advances and improved screening practices have resulted in a substantial increase diagnosis of ductal carcinoma situ (DCIS). Accounting for approximately 20% to 30% breast cancer cases, DCIS is associated with low mortality rates, but local relapse matter concern, death may occur cases insufficient treatment. As demonstrated previous studies, one predictive factor age, younger patients having higher risk an ipsilateral tumor recurrence as or invasive cancer. Other factors include close positive surgical margins necrosis. Whole-breast irradiation following breastconserving surgery statistically significantly reduces compared alone. Accepted current standard care, adjuvant whole-breast radiotherapy has been reduce noninvasive undergoing breast-conservation therapy 4 large prospective randomized controlled trials (National Surgical Adjuvant Breast Bowel Project B-17, European Organisation Research Treatment Cancer 10853, United Kingdom/Australia New Zealand, SweDCIS) Oxford overview. Although complementary boost bed shown considerably improve disease control cancer, this strategy remains controversial DCIS, majority studies resulting no therapeutic survival advantage. In study involving largest populations date, Rakovitch colleagues focused on population individuals confirmed who were treated radiotherapy. The participants followed 10 which allowed high power provided data 10-year rates recurrence-free (LRFS). included 235 than 45 years although median age was 56 years. addition, it had before radiotherapy, 39% whom underwent hypofractionated scheme 40-44 Gy 16 fractions rather conventional 50 25 fractions. This study, unique several patient treatment characteristics, did not identify subset women administration lower rate