Strahlentherapie beim Mammakarzinom – Neues und Bewährtes

Die Strahlentherapie ist beim Mammakarzinom ein Bestandteil der multimodalen Therapie. Dieser Beitrag befasst sich mit bewährten Behandlungskonzepten und ergänzt diese mit aktuellen Neuerungen. Die hier dargestellten Themen beziehen sich auf Bestrahlungsindikationen sowie die Bestrahlungskonzepte und -techniken.

Kernaussagen

• Nach brusterhaltender Operation sollte die Bestrahlung der Brust mit einer moderaten Hypofraktionierung erfolgen.

• Der Boost senkt das Lokalrezidivrisiko signifikant, wobei ältere Patientinnen aufgrund des absolut niedrigeren Rückfallrisikos weniger von der Boost-Bestrahlung profitieren; jüngere Patientinnen aufgrund des absolut höheren Rückfallrisikos mehr.

• Bei höherem Risiko (> T1, G3, triplenegativ) ist auch bei postmenopausalen Patientinnen eine Boost-Bestrahlung indiziert.

• Bei älteren Patientinnen mit einem sehr niedrigen Rückfallrisiko kann auf eine Nachbestrahlung nach brusterhaltender Operation unter Inkaufnahme eines etwas erhöhten Lokalrezidivrisikos verzichtet werden.

• Die Bestrahlung der linken Brust sollte in Deep-Inspiration-Breath-hold-Technik durchgeführt werden.

Schlüsselwörter

Mammakarzinom - Strahlentherapie - Fraktionierung - Lymphabflussbestrahlung - Teilbrustbestrahlung

Publication History

Article published online:
08 December 2021

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