Strahlentherapie beim Mammakarzinom:
Was ist Standard? Was ist Zukunft?

Zusammenfassung

Die Strahlentherapie ist seit vielen Jahren ein fester Bestandteil in der Therapie des Mammakarzinoms. Der Kernpunkt der kontroversen wissenschaftlichen Debatte der letzten Jahre betraf die Frage, ob neben der unstrittigen Verbesserung der lokalen Kontrolle auch ein positiver Effekt auf das Gesamtüberleben resultiert. Diese Frage kann zwischenzeitlich als weitgehend geklärt angesehen werden. Mehrere Studien der letzten Jahren bestätigen eindeutig, dass durch die Verhinderung von lokalen Rezidiven auch das Risiko von Fernmetastasen verringert und die Überlebensrate verbessert werden kann. Diese Daten haben weltweit zu einer Neubewertung der adjuvanten Strahlentherapie geführt. Der folgende Artikel fasst die wesentlichen Studienergebnisse und Empfehlungen für die etablierten Indikationen zusammen.

Abstract

For many years radiotherapy has been an integral part of the treatment of breast cancer. The focal point of the controversial scientific debate during the past few years was whether besides the undisputed improvement in local control there would also be a positive effect on overall survival. This question can now be considered as largely settled. Several studies conducted during the last few years definitely confirm that the prevention of local relapses can also reduce the risk of distant metastases and enhance the survival rate. These data led to a world-wide re-evaluation of adjuvant radiotherapy. The following article summarizes the essential results of the studies and the recommendations for the established indications.

Mammakarzinom - Radiotherapie - Leitlinien - Nebenwirkungen

Breast cancer - radiotherapy - toxicity - guidelines

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1 Das lobuläre In-situ-Karzinom (LCIS) gilt nicht als obligate Präkanzerose, sondern lediglich als Risikofaktor für das Entstehen anderer invasiver Karzinome. Die Therapie der Wahl ist die Tumorektomie mit konsequenter Nachbeobachtung. Eine Nachbestrahlung ist beim LCIS nicht indiziert.