Late Toxicity of Radiotherapy: A Problem or a Challenge for the Radiation Oncologist?
Identifieur interne : 004783 ( Pmc/Corpus ); précédent : 004782; suivant : 004784Late Toxicity of Radiotherapy: A Problem or a Challenge for the Radiation Oncologist?
Auteurs : Cordula Petersen ; Florian WürschmidtSource :
- Breast Care [ 1661-3791 ] ; 2011.
Abstract
Large randomized clinical trials have established radiotherapy in conjunction with adjuvant systemic treatment as standard treatment in breast cancer after both mastectomy and lumpectomy. Although standard radiation therapy is well tolerated by the majority of patients, some patients might suffer from late normal tissue effects.
The literature on radiotherapy following surgery of breast cancer was reviewed with regard to late toxicity.
Radiotherapy may, to some degree, cause persistent pain in the breast, arm and shoulder in up to 30–50% of patients after 3–5 years, lymphedema in 15–25%, and restriction of arm and shoulder movement in 35%. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy may cause damage to the heart. However, using modern radiotherapy techniques, the available evidence does not suggest a higher incidence of cardiac mortality.
This review updates the database on toxicity from radiation in breast cancer. Advances in research of radiation-induced late effects may lead to improved treatment choices for breast cancer patients including radiotherapy and may improve quality of life after surviving breast cancer.
Url:
DOI: 10.1159/000334220
PubMed: 22619647
PubMed Central: 3357174
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PMC:3357174Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Late Toxicity of Radiotherapy: A Problem or a Challenge for the Radiation Oncologist?</title><author><name sortKey="Petersen, Cordula" sort="Petersen, Cordula" uniqKey="Petersen C" first="Cordula" last="Petersen">Cordula Petersen</name><affiliation><nlm:aff id="aff1">Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Germany</nlm:aff></affiliation></author><author><name sortKey="Wurschmidt, Florian" sort="Wurschmidt, Florian" uniqKey="Wurschmidt F" first="Florian" last="Würschmidt">Florian Würschmidt</name><affiliation><nlm:aff id="aff2">Radiologische Allianz Hamburg, Germany</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22619647</idno><idno type="pmc">3357174</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357174</idno><idno type="RBID">PMC:3357174</idno><idno type="doi">10.1159/000334220</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">004783</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004783</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Late Toxicity of Radiotherapy: A Problem or a Challenge for the Radiation Oncologist?</title><author><name sortKey="Petersen, Cordula" sort="Petersen, Cordula" uniqKey="Petersen C" first="Cordula" last="Petersen">Cordula Petersen</name><affiliation><nlm:aff id="aff1">Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Germany</nlm:aff></affiliation></author><author><name sortKey="Wurschmidt, Florian" sort="Wurschmidt, Florian" uniqKey="Wurschmidt F" first="Florian" last="Würschmidt">Florian Würschmidt</name><affiliation><nlm:aff id="aff2">Radiologische Allianz Hamburg, Germany</nlm:aff></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="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Large randomized clinical trials have established radiotherapy in conjunction with adjuvant systemic treatment as standard treatment in breast cancer after both mastectomy and lumpectomy. Although standard radiation therapy is well tolerated by the majority of patients, some patients might suffer from late normal tissue effects.</p></sec><sec><title>Methods</title><p>The literature on radiotherapy following surgery of breast cancer was reviewed with regard to late toxicity.</p></sec><sec><title>Results</title><p>Radiotherapy may, to some degree, cause persistent pain in the breast, arm and shoulder in up to 30–50% of patients after 3–5 years, lymphedema in 15–25%, and restriction of arm and shoulder movement in 35%. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy may cause damage to the heart. However, using modern radiotherapy techniques, the available evidence does not suggest a higher incidence of cardiac mortality.</p></sec><sec><title>Conclusions</title><p>This review updates the database on toxicity from radiation in breast cancer. Advances in research of radiation-induced late effects may lead to improved treatment choices for breast cancer patients including radiotherapy and may improve quality of life after surviving breast cancer.</p></sec></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 GmbH</publisher-name><publisher-loc>Lörracherstrasse 16 a, P.O. Box · Postfach · Case postale, D–79095, Freiburg, Germany · Deutschland · Allemagne, Phone: +49 761 45 20 70, Fax: +49 761 4 52 07 14, information@karger.de</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22619647</article-id><article-id pub-id-type="pmc">3357174</article-id><article-id pub-id-type="doi">10.1159/000334220</article-id><article-id pub-id-type="publisher-id">brc-0006-0369</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article · Übersichtsarbeit</subject></subj-group></article-categories><title-group><article-title>Late Toxicity of Radiotherapy: A Problem or a Challenge for the Radiation Oncologist?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Petersen</surname><given-names>Cordula</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Würschmidt</surname><given-names>Florian</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref></contrib></contrib-group><aff id="aff1"><sup>a</sup>Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Germany</aff><aff id="aff2"><sup>b</sup>Radiologische Allianz Hamburg, Germany</aff><author-notes><corresp id="cor1">*Prof. Dr. med. Cordula Petersen, Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany, Tel. +49 40 7410–57351, Fax −56710, <email>cor.petersen@uke.de</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>31</day><month>10</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>10</month><year>2012</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>6</volume><issue>5</issue><fpage>369</fpage><lpage>374</lpage><permissions><copyright-statement>Copyright © 2011 by S. Karger GmbH, Freiburg</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><sec><title>Background</title><p>Large randomized clinical trials have established radiotherapy in conjunction with adjuvant systemic treatment as standard treatment in breast cancer after both mastectomy and lumpectomy. Although standard radiation therapy is well tolerated by the majority of patients, some patients might suffer from late normal tissue effects.</p></sec><sec><title>Methods</title><p>The literature on radiotherapy following surgery of breast cancer was reviewed with regard to late toxicity.</p></sec><sec><title>Results</title><p>Radiotherapy may, to some degree, cause persistent pain in the breast, arm and shoulder in up to 30–50% of patients after 3–5 years, lymphedema in 15–25%, and restriction of arm and shoulder movement in 35%. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy may cause damage to the heart. However, using modern radiotherapy techniques, the available evidence does not suggest a higher incidence of cardiac mortality.</p></sec><sec><title>Conclusions</title><p>This review updates the database on toxicity from radiation in breast cancer. Advances in research of radiation-induced late effects may lead to improved treatment choices for breast cancer patients including radiotherapy and may improve quality of life after surviving breast cancer.</p></sec></abstract><trans-abstract xml:lang="de"><sec><title>Hintergrund</title><p>Große, randomisierte Studien belegen die Bedeutung der Strahlentherapie in Kombination mit systemischer Therapie in der standardisierten Behandlung des Mammakarzinoms sowohl nach Mastektomie als auch nach brusterhaltender Therapie. Auch wenn die Mehrheit der Patientinnen die Behandlung gut toleriert, existieren Spätfolgen, die die Gesundheit der behandelten Patientinnen nachhaltig beeinflussen können.</p></sec><sec><title>Methoden</title><p>Die vorliegende Literatur zur postoperativen Bestrahlung des Mammakarzinoms wurde hinsichtlich radiogener Spätfolgen gesichtet.</p></sec><sec><title>Ergebnisse</title><p>Die Strahlentherapie als lokale Behandlungsform kann in einer Größenordnung von 30–50% der Patientinnen 3–5 Jahre nach Therapie bleibende Schmerzen im Brustareal, Arm-und Schulterbereich verursachen, ein Lymphödem in 15–25% der Patientinnen, und eine Einschränkung der Schulterbeweglichkeit in bis zu 35%. Eine potentielle Kardiotoxizität im Rahmen der Strahlentherapie muss Berücksichtigung finden, da auch medikamentöse Substanzen wie Anthracycline und Trastuzumab die kardiale Funktion beeinträchtigen können. Allerdings zeigen Daten zu modernen Bestrahlungstechniken keine erhöhte Inzidenz bezüglich der kardialen Mortalität.</p></sec><sec><title>Schlussfolgerungen</title><p>Die vorliegende Übersichtsarbeit aktualisiert die Datenbasis zur Spättoxizität nach Strahlentherapie bei Brustkrebs. Fortschritte in der Erforschung radiogener Spätfolgen lassen erwarten, dass sich die Behandlungsentscheidungen für Brustkrebspatienten unter Einschluss der Strahlentherapie auch zukünftig verbessern und damit zu einer Verbesserung der Lebensqualität beitragen.</p></sec></trans-abstract><kwd-group><title>Keywords</title><kwd>Breast cancer</kwd><kwd>Late effects</kwd><kwd>Radiotherapy</kwd></kwd-group><counts><table-count count="1"></table-count><ref-count count="59"></ref-count><page-count count="6"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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