Radiotherapy of the Lymphatic Pathways in Early Breast Cancer
Identifieur interne : 000F32 ( Pmc/Checkpoint ); précédent : 000F31; suivant : 000F33Radiotherapy of the Lymphatic Pathways in Early Breast Cancer
Auteurs : Marie-Luise Sautter-Bihl [Allemagne] ; Felix Sedlmayer [Autriche]Source :
- Breast Care [ 1661-3791 ] ; 2015.
Abstract
International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.
Url:
DOI: 10.1159/000438662
PubMed: 26600761
PubMed Central: 4608631
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Radiotherapy of the Lymphatic Pathways in Early Breast Cancer</title><author><name sortKey="Sautter Bihl, Marie Luise" sort="Sautter Bihl, Marie Luise" uniqKey="Sautter Bihl M" first="Marie-Luise" last="Sautter-Bihl">Marie-Luise Sautter-Bihl</name><affiliation wicri:level="1"><nlm:aff id="aff1">Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe</wicri:regionArea><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion></affiliation></author><author><name sortKey="Sedlmayer, Felix" sort="Sedlmayer, Felix" uniqKey="Sedlmayer F" first="Felix" last="Sedlmayer">Felix Sedlmayer</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26600761</idno><idno type="pmc">4608631</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608631</idno><idno type="RBID">PMC:4608631</idno><idno type="doi">10.1159/000438662</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000485</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000485</idno><idno type="wicri:Area/Pmc/Curation">000485</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000485</idno><idno type="wicri:Area/Pmc/Checkpoint">000F32</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000F32</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Radiotherapy of the Lymphatic Pathways in Early Breast Cancer</title><author><name sortKey="Sautter Bihl, Marie Luise" sort="Sautter Bihl, Marie Luise" uniqKey="Sautter Bihl M" first="Marie-Luise" last="Sautter-Bihl">Marie-Luise Sautter-Bihl</name><affiliation wicri:level="1"><nlm:aff id="aff1">Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe</wicri:regionArea><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion><wicri:noRegion>Städtisches Klinikum Karlsruhe</wicri:noRegion></affiliation></author><author><name sortKey="Sedlmayer, Felix" sort="Sedlmayer, Felix" uniqKey="Sedlmayer F" first="Felix" last="Sedlmayer">Felix Sedlmayer</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author></analytic><series><title level="j">Breast Care</title><idno type="ISSN">1661-3791</idno><idno type="eISSN">1661-3805</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><p>International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.</p></div></front></TEI><pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Care (Basel)</journal-id><journal-id journal-id-type="iso-abbrev">Breast Care (Basel)</journal-id><journal-id journal-id-type="publisher-id">BRC</journal-id><journal-title-group><journal-title>Breast Care</journal-title></journal-title-group><issn pub-type="ppub">1661-3791</issn><issn pub-type="epub">1661-3805</issn><publisher><publisher-name>S. Karger AG</publisher-name><publisher-loc>Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26600761</article-id><article-id pub-id-type="pmc">4608631</article-id><article-id pub-id-type="doi">10.1159/000438662</article-id><article-id pub-id-type="publisher-id">brc-0010-0254</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Radiotherapy of the Lymphatic Pathways in Early Breast Cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sautter-Bihl</surname><given-names>Marie-Luise</given-names></name><xref ref-type="aff" rid="aff1">a</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Sedlmayer</surname><given-names>Felix</given-names></name><xref ref-type="aff" rid="aff2">b</xref></contrib></contrib-group><aff id="aff1"><sup>a</sup>Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Germany</aff><aff id="aff2"><sup>b</sup>Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Salzburg, Austria</aff><author-notes><corresp id="cor1">*Prof. Dr. med. Marie-Luise Sautter-Bihl, Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe, Moltkestraße 90, 76133 Karlsruhe, Germany, <email>Marie-Luise.Sautter-Bihl@klinikum-karlsruhe.de</email></corresp></author-notes><pub-date pub-type="ppub"><month>8</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>19</day><month>8</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>8</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 12 months and
0 days and was based on the
<volume>10</volume><issue>4</issue><fpage>254</fpage><lpage>258</lpage><permissions><copyright-statement>Copyright © 2015 by S. Karger AG, Basel</copyright-statement><copyright-year>2015</copyright-year></permissions><abstract><title>Summary</title><p>International guidelines reveal substantial differences regarding indications for regional nodal irradiation (RNI). Recently, several randomized studies provided new insights and these are discussed here. Patients with 1-3 positive nodes seem to profit from RNI compared to whole-breast (WBI) or chest-wall irradiation (CWI) alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and 1 meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel nodes or microscopic metastases on prognosis are equivocal. Recent data suggest that the current restrictive use of RNI should be scrutinized, as the hazard-benefit relation appears to shift towards an improvement of outcome.</p></abstract><kwd-group><title>Keywords</title><kwd>Breast cancer</kwd><kwd>Radiotherapy</kwd><kwd>Regional nodal irradiation</kwd></kwd-group><counts><ref-count count="41"></ref-count><page-count count="5"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Allemagne</li><li>Autriche</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Sautter Bihl, Marie Luise" sort="Sautter Bihl, Marie Luise" uniqKey="Sautter Bihl M" first="Marie-Luise" last="Sautter-Bihl">Marie-Luise Sautter-Bihl</name></noRegion></country><country name="Autriche"><noRegion><name sortKey="Sedlmayer, Felix" sort="Sedlmayer, Felix" uniqKey="Sedlmayer F" first="Felix" last="Sedlmayer">Felix Sedlmayer</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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