早期乳腺癌患者保乳术后免除放疗的研究进展  

Research progress of exemption from radiotherapy after breast-conserving surgery in patients with early-stage breast cancer

作　　者：刘茗 刘帅 张楠[1,2] Liu Ming;Liu Shuai;Zhang Nan(Medical Integration and Practice Center,Shandong University,Jinan 250012,China;Breast Center,Jinan Central Hospital,Shandong First Medical University,Jinan 250013,China)

机构地区：[1]山东大学医学融合与实践中心,济南250012 [2]山东第一医科大学附属济南市中心医院乳腺疾病诊疗中心,济南250013

出　　处：《国际医药卫生导报》2024年第3期357-362,共6页International Medicine and Health Guidance News

基　　金：山东省自然科学基金(ZR2020QH252);山东省医学会临床科研资金-齐鲁专项(YXH2022ZX02168);济南市卫生健康委员会大数据科技计划(2022-YBD-03)。

摘　　要：乳腺癌患者保乳手术后行放疗是早期乳腺癌的标准治疗模式。由于影像学、手术、分子病理学的进步,乳腺癌患者中低风险人群可以进行放射治疗的降级,甚至合理地免除放疗来减少不良反应。本文综述了乳腺癌放疗降级的一个演变过程,回顾相关病理检测及基因检测在乳腺癌放疗中对其预后的评估作用,并讨论激素受体阳性乳腺癌患者结合多种分子检测进行免除放疗的相关试验,利用现有的肿瘤生物学和分子检测精准确定保乳术后可以安全免除放疗的患者群体。Radiotherapy after breast-conserving surgery for patients with breast cancer is the standard treatment modality for early-stage breast cancer.Due to advances in imaging,surgery,and molecular pathology,downgrading of radiotherapy or even reasonable exemption from radiotherapy can be performed in low-risk patients with breast cancer to minimize the adverse effects of radiotherapy.This article reviews the evolutionary process of radiotherapy downgrading in breast cancer and the role of relevant pathological tests and genetic tests in assessing the prognosis of patients with breast cancer in radiotherapy,and discusses relevant trials on patients with hormone receptor-positive breast cancer combining multiple molecular tests for exemption from radiotherapy to identify patient groups that can be safely exempted from radiotherapy after breast-conserving surgery using available tumor biology and molecular predictions.

关 键 词：乳腺癌 保乳术后 放疗降级 分子检测 预后 进展 

分 类 号：R737.9[医药卫生—肿瘤]