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CC BY-NC-ND 4.0 · Senologie - Zeitschrift für Mammadiagnostik und -therapie 2024; 21(04): 273-281
DOI: 10.1055/a-2289-0436
Review

Modern radiotherapy for breast cancer: Update and new developments

Article in several languages: English | deutsch
Eva Meixner
1   Abteilung für RadioOnkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2   Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Deutschland
3   National Center for Tumor diseases (NCT), Heidelberg, Deutschland
4   Heidelberger Ionenstrahl-Therapiezentrum (HIT), Heidelberg, Deutschland
,
Jürgen Debus
1   Abteilung für RadioOnkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2   Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Deutschland
3   National Center for Tumor diseases (NCT), Heidelberg, Deutschland
4   Heidelberger Ionenstrahl-Therapiezentrum (HIT), Heidelberg, Deutschland
5   Clinical Cooperation Unit Radiation Oncology, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
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Abstract

The delivery of radiotherapy for breast cancer has evolved significantly over the years. The aim of this review is to highlight important developments and current concepts. Postoperative hypofractionated three-dimensional conformal or intensity-modulated photon radiotherapy continues to be the standard application after breast-conserving surgery to improve local control. New therapy techniques in deep inspiration breath hold or physical-biological advantages of proton beam therapy offer innovative therapy methods with regard to the protection of normal tissue and reduced cardiotoxicity. Ultra-hypofractionated therapy concepts and the integration of a simultaneous integrated boost in hypofractionated therapy concepts also enable the duration of treatment to be reduced to a few days or weeks. In low-risk constellations, the radiation volume may also be de-escalated to partial breast irradiation, and if life expectancy is severely restricted at the same time, the omission of postoperative radiotherapy might be critically discussed. The oncological benefit of an irradiation of the regional lymph node regions continues to be confirmed in locally advanced, node-positive carcinomas and further enables the omission of surgical axillary lymph node dissection with low morbidity in individualized therapy approaches.

Keywords

deep inspiration breath hold - proton beam radiotherapy - cardiotoxicity - partial breast irradiation - RT omission


Publication History

Article published online:
09 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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