文档介绍：乳腺癌低分次大分割放射治疗
Hypofractionated Radiation Therapy for Breast Cancer
1
可编辑课件PPT
研究背景
技术路线
临床优势及问题
2
可编辑课件PPT
研究背景
一、早期乳癌保乳术后
二、乳腺癌根治/改良根治术后
T3,4 N:≥4
3
可编辑课件PPT
Women receiving radiation therapy following breast conserving surgery had a 19% reduction in 5-year local recurrence (7 vs. 26%) which translated into a % reduction in 15-year over all mortality ( %).
Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-yearsurvival: an overview of the randomised trials. Lancet 2005; 36 6 :2087–2106.
4
可编辑课件PPT
receiving postmastectomy radiation had a 17% reduction in 5-year local re- currence ( vs. %) which translated into a % reduction in15-year overall mortality (. %)
Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-yearsurvival: an overview of the randomised trials. Lancet 2005; 36 6 :2087–2106.
5
可编辑课件PPT
乳腺癌放射治疗的新趋势：精，小，快
精：精确确定放射治疗在综合治疗中的作用
p T1,2 N :1-3 个 ?
小：放射治疗的范围缩小，保乳术后放疗时部分乳腺照射受到重视 （APBI）
快：低分次大分割放射治疗（Hypofractionation的应用）
6
可编辑课件PPT
低分次大分割放射治疗 （Hypofractionation ）
定义
增大单次照射剂量（>2Gy），减少总次数，减少照射总剂量，从而缩短总的治疗时间。
7
可编辑课件PPT
研究背景
放射生物学
肿瘤放疗方面公认的观点：
放疗的分割方式取决于肿瘤组织的α/β值
1978年Withers用等效总剂量和分次剂量做图显示晚反应组织的曲线比早反应组织陡，表明晚反应组织对分次剂量的变化更敏感
8
可编辑课件PPT
体外试验测得乳腺癌细胞的α/β值大约为4
MatthewsJ,MeekerB, of human tumor cell lines in vitro to fractionated irradiation. International Journal of Radiation Oncology Biology and Physics 1989;16:133e8.
SteelG,DeaconJ, dose-rate effect in human tumour and Oncology 1987;9:299e310.
9
可编辑课件PPT
Castro JR 将放射生物学应用于临床回顾性资料，最早得出大分割治疗是安全有效的模式。
Douglas BG, Castro JR. Novel fractionation schemes and high linear energy transfer. Prog Exp Tu