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【medical-news】短程加量照射对于某些乳腺癌是可行的

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这个帖子发布于11年零31天前，其中的信息可能已发生改变或有所发展。
Shorter, More Intense Radiation OK for Some Breast Cancers

WEDNESDAY, Nov. 4 (HealthDay News) -- A shorter, more intense course of whole-breast radiation works as well as the traditional six-week course, at least for some early-stage breast cancers, a new study shows.
"This concept of a shorter length of treatment is gaining acceptance," said Dr. Manjeet Chadha, associate chair of radiation oncology at Beth Israel Medical Center and associate professor of radiation oncology at Albert Einstein College of Medicine, both in New York City. Chadha led the study and is scheduled to present the results Wednesday at the American Society for Radiation Oncology annual meeting, in Chicago.
Researchers previously have tried to investigate whether they can alter the duration of radiation therapy or the volume, Chadha said. "My study focuses on the duration of it," she said.
In her three-week treatment -- called accelerated hypofractionated whole breast irradiation -- a woman gets the entire affected breast irradiated and receives a ''boost,'' or extra dose, at the site where the tumor was removed. Other approaches include giving a boost dose after the entire radiation treatment to the whole breast is completed.
Chadha's study is ongoing, but she planned to report on 122 patients with early-stage breast cancers who underwent lumpectomies followed by the accelerated treatment. They were then tracked for a median of two and a half years (half followed longer, half less). The patients' median age was 66.
No relapses were noted, and the three-year survival rate was nearly 95 percent, Chadha said.
''It sounds encouraging," she said of her results. To further evaluate the accelerated treatment, she compared the first 50 patients on the briefer approach to a matched group of 70 patients who got the more traditional six-week radiation treatment.
Side effects, such as skin irritation and redness, were similar, she found. ''There was no difference in fatigue or breast edema [swelling]," she said. The cosmetic results were satisfactory, too.
The new study adds some valuable information for doctors trying to decide for individual women which radiation treatment approach might be best, said Dr. Nayana Vora, a professor of radiation oncology and associate member of the developmental cancer therapeutics program at the City of Hope Comprehensive Cancer Center in Duarte, Calif.
''It's a short follow-up,'' she said, noting that some side effects may surface later. But, she noted that a study outside the United States that looked at the briefer treatments has followed patients for up to 12 years with results similar to Chadha's study.
''Very few studies have been documented in the U.S. with external whole beam [to the whole breast] and a concomitant boost," Vora said. ''It tell us that, yes, patients can be treated with a short course of radiation treatment. Will it become the standard of care? I don't know."
While Vora typically offers her patients the six-week treatment unless they can't commit to that time period because of transportation problem or other obstacles, she said she now may consider the shorter treatment.
In another study to be presented at the oncology meeting, researchers reported that breast cancer patients who have a mastectomy and then receive radiation to the lymph nodes behind the breast bone (the internal mammary lymph nodes) do not live longer than those who don't get those nodes treated.
The study evaluated 1,334 women with stage 1 or 2 breast cancers that had spread to the axillary lymph nodes under the arms or whose original tumor was in a central, internal location. All got radiation to the chest wall and nodes above the collar bone. But half got the internal mammary radiation and half did not.
After a decade, survival differences between the groups were small, with 60 percent of those who didn't get the extra radiation still alive, and 63 percent of those who got it surviving.
Most radiation oncologists are reluctant to radiate the internal mammary nodes, Vora explained, because of their proximity to the heart.
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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
2009-11-05 21:13
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Shorter, More Intense Radiation OK for Some Breast Cancers
短程加量照射对于某些乳腺癌是可行的

WEDNESDAY, Nov. 4 (HealthDay News) -- A shorter, more intense course of whole-breast radiation works as well as the traditional six-week course, at least for some early-stage breast cancers, a new study shows.

11月4日星期三（每日健康新闻）----一个最新研究显示短程加量全乳腺照射至少在一些早期乳腺癌中疗效与传统的6周疗程一样好。

"This concept of a shorter length of treatment is gaining acceptance," said Dr. Manjeet Chadha, associate chair of radiation oncology at Beth Israel Medical Center and associate professor of radiation oncology at Albert Einstein College of Medicine, both in New York City. Chadha led the study and is scheduled to present the results Wednesday at the American Society for Radiation Oncology annual meeting, in Chicago.
以色列贝丝医学中心放射肿瘤学系副主席和艾伯特.爱因斯坦医学院放射肿瘤学系副教授Manjeet Chadha医生说，短程加量照射的概念已被接受。由Chadha领衔的这个研究计划将这个研究结果在芝加哥举行的美国放疗年会上露面。

Researchers previously have tried to investigate whether they can alter the duration of radiation therapy or the volume, Chadha said. "My study focuses on the duration of it," she said.
Chadha说，研究者以前曾设法去研究变化放射疗程和治疗靶区，她接着说：“我主要研究变化放疗的疗程。”

In her three-week treatment -- called accelerated hypofractionated whole breast irradiation -- a woman gets the entire affected breast irradiated and receives a ''boost,'' or extra dose, at the site where the tumor was removed. Other approaches include giving a boost dose after the entire radiation treatment to the whole breast is completed.
她的三周治疗就是全乳腺的加速超分割放疗，乳腺癌妇女要接受受累乳腺的全乳照射并且接受瘤床区的推量或额外剂量。其他的方法包括全乳腺照射完成后的加量是完美的。

Chadha's study is ongoing, but she planned to report on 122 patients with early-stage breast cancers who underwent lumpectomies followed by the accelerated treatment. They were then tracked for a median of two and a half years (half followed longer, half less). The patients' median age was 66.
Chadha的研究正在进行，她准备报告122例接受肿块切除的早期乳腺癌患者行加速照射。这些病人被随访中位时间为两年半（一半长一些，一半短一些）。病人的中位年龄66岁

No relapses were noted, and the three-year survival rate was nearly 95 percent, Chadha said.
Chadha说，没有复发记录，三年生存率接近95%。

''It sounds encouraging," she said of her results. To further evaluate the accelerated treatment, she compared the first 50 patients on the briefer approach to a matched group of 70 patients who got the more traditional six-week radiation treatment.
谈及她的研究结果：“目前看起来十分鼓舞人心。”为了进一步评价加速治疗的效果，她把第一组接受短程加速治疗的50个病人与第二组接受常规6周放疗的70个病人作对比。

Side effects, such as skin irritation and redness, were similar, she found. ''There was no difference in fatigue or breast edema [swelling]," she said. The cosmetic results were satisfactory, too.

她发现两者副作用方面，例如放射性皮肤反应和红斑差不多。她说：“两者在疲劳和乳腺水肿方面无明显差异。”美容效果也是令人满意的。

The new study adds some valuable information for doctors trying to decide for individual women which radiation treatment approach might be best, said Dr. Nayana Vora, a professor of radiation oncology and associate member of the developmental cancer therapeutics program at the City of Hope Comprehensive Cancer Center in Duarte, Calif.
加州Duarte希望综合性肿瘤中心癌症治疗计划项目成员、放射肿瘤学教授Nayana Vora医生说，这个最新的研究可以提供医生在给每一个乳腺癌患者做放疗计划时，可选择一个做好的治疗方法。

''It's a short follow-up,'' she said, noting that some side effects may surface later. But, she noted that a study outside the United States that looked at the briefer treatments has followed patients for up to 12 years with results similar to Chadha's study.

这只是一个短期的随访，她说，并指出可能会发生迟发的表面副反应。但是她指出美国以外的一个研究显示短程治疗后随访12年的结果和Chadha得研究一致。
''Very few studies have been documented in the U.S. with external whole beam [to the whole breast] and a concomitant boost," Vora said. ''It tell us that, yes, patients can be treated with a short course of radiation treatment. Will it become the standard of care? I don't know."
Vora说：“目前美国有很少关于全乳放疗加瘤床加量的文献报道，他告诉我们病人完全可以接受短程放疗，但这会不会成为一个标准治疗，我不知道。”

While Vora typically offers her patients the six-week treatment unless they can't commit to that time period because of transportation problem or other obstacles, she said she now may consider the shorter treatment.
但Vora仍给他的病人做经典的传统6周照射，除非病人因为交通运输问题或其他障碍不能耐受次治疗疗程。她说她正在考虑短程治疗。

In another study to be presented at the oncology meeting, researchers reported that breast cancer patients who have a mastectomy and then receive radiation to the lymph nodes behind the breast bone (the internal mammary lymph nodes) do not live longer than those who don't get those nodes treated.

在肿瘤学会议上，有另一项研究报告称，乳腺癌患者接受乳房切除术后再进行胸骨后淋巴结（内乳淋巴结）照射没有比不接受内乳淋巴结照射的获得更长的生存期。
The study evaluated 1,334 women with stage 1 or 2 breast cancers that had spread to the axillary lymph nodes under the arms or whose original tumor was in a central, internal location. All got radiation to the chest wall and nodes above the collar bone. But half got the internal mammary radiation and half did not.
这个研究评价了1334例1期或2期乳腺癌患者腋窝淋巴结转移的病人或原发肿瘤位于中心或内侧象限的病人，所有的病人接受胸壁照射和锁骨上照射，但一半接受了内乳淋巴结照射，而另一半未接受内乳淋巴结照射。

After a decade, survival differences between the groups were small, with 60 percent of those who didn't get the extra radiation still alive, and 63 percent of those who got it surviving.

十年后两组间的生存差异非常小，没有接受额外加量的乳腺癌患者的十年生存率为60%，接受额外加量的乳腺癌患者的十年生存率为63%。
Most radiation oncologists are reluctant to radiate the internal mammary nodes, Vora explained, because of their proximity to the heart.
Vora解释说，绝大大部分放射肿瘤学家不愿照射内乳淋巴结，因为内乳淋巴结距离心脏太近。

编译：

短程加量照射对于某些乳腺癌是可行的

11月4日星期三（每日健康新闻）----一个最新研究显示短程加量全乳腺照射至少在一些早期乳腺癌中疗效与传统的6周疗程一样好。

以色列贝丝医学中心放射肿瘤学系副主席和艾伯特.爱因斯坦医学院放射肿瘤学系副教授Manjeet Chadha医生说，短程加量照射的概念已被接受。由Chadha领衔的这个研究计划将这个研究结果在芝加哥举行的美国放疗年会上露面。

Chadha说，研究者以前曾设法去研究变化放射疗程和治疗靶区，她接着说：“我主要研究变化放疗的疗程。”

她的三周治疗就是全乳腺的加速超分割放疗，乳腺癌妇女要接受受累乳腺的全乳照射并且接受瘤床区的推量或额外剂量。其他的方法包括全乳腺照射完成后的加量是完美的。

Chadha的研究正在进行，她准备报告122例接受肿块切除的早期乳腺癌患者行加速照射。这些病人被随访中位时间为两年半（一半长一些，一半短一些）。病人的中位年龄66岁

Chadha说，没有复发记录，三年生存率接近95%。

谈及她的研究结果：“目前看起来十分鼓舞人心。”为了进一步评价加速治疗的效果，她把第一组接受短程加速治疗的50个病人与第二组接受常规6周放疗的70个病人作对比。

她发现两者副作用方面，例如放射性皮肤反应和红斑差不多。她说：“两者在疲劳和乳腺水肿方面无明显差异。”美容效果也是令人满意的。

加州Duarte希望综合性肿瘤中心癌症治疗计划项目成员、放射肿瘤学教授Nayana Vora医生说，这个最新的研究可以提供医生在给每一个乳腺癌患者做放疗计划时，可选择一个做好的治疗方法。

这只是一个短期的随访，她说，并指出可能会发生迟发的表面副反应。但是她指出美国以外的一个研究显示短程治疗后随访12年的结果和Chadha得研究一致。

Vora说：“目前美国有很少关于全乳放疗加瘤床加量的文献报道，他告诉我们病人完全可以接受短程放疗，但这会不会成为一个标准治疗，我不知道。”

但Vora仍给他的病人做经典的传统6周照射，除非病人因为交通运输问题或其他障碍不能耐受次治疗疗程。她说她正在考虑短程治疗。

在肿瘤学会议上，有另一项研究报告称，乳腺癌患者接受乳房切除术后再进行胸骨后淋巴结（内乳淋巴结）照射没有比不接受内乳淋巴结照射的获得更长的生存期。

这个研究评价了1334例1期或2期乳腺癌患者腋窝淋巴结转移的病人或原发肿瘤位于中心或内侧象限的病人，所有的病人接受胸壁照射和锁骨上照射，但一半接受了内乳淋巴结照射，而另一半未接受内乳淋巴结照射。

十年后两组间的生存差异非常小，没有接受额外加量的乳腺癌患者的十年生存率为60%，接受额外加量的乳腺癌患者的十年生存率为63%。

Vora解释说，绝大大部分放射肿瘤学家不愿照射内乳淋巴结，因为内乳淋巴结距离心脏太近。
2009-11-05 21:14
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编译：1238字

短程加量照射对于某些乳腺癌是可行的

11月4日星期三（每日健康新闻）----一个最新研究显示短程加量全乳腺照射至少在一些早期乳腺癌中疗效与传统的6周疗程一样好。

以色列贝丝医学中心放射肿瘤学系副主席和艾伯特.爱因斯坦医学院放射肿瘤学系副教授Manjeet Chadha医生说，短程加量照射的概念已被接受。由Chadha领衔的这个研究计划将这个研究结果在芝加哥举行的美国放疗年会上露面。

Chadha说，研究者以前曾设法去研究变化放射疗程和治疗靶区，她接着说：“我主要研究变化放疗的疗程。”

她的三周治疗就是全乳腺的加速超分割放疗，乳腺癌妇女要接受受累乳腺的全乳照射并且接受瘤床区的推量或额外剂量。其他的方法包括全乳腺照射完成后的加量是完美的。

Chadha的研究正在进行，她准备报告122例接受肿块切除的早期乳腺癌患者行加速照射。这些病人被随访中位时间为两年半（一半长一些，一半短一些）。病人的中位年龄66岁

Chadha说，没有复发记录，三年生存率接近95%。

谈及她的研究结果：“目前看起来十分鼓舞人心。”为了进一步评价加速治疗的效果，她把第一组接受短程加速治疗的50个病人与第二组接受常规6周放疗的70个病人作对比。

她发现两者副作用方面，例如放射性皮肤反应和红斑差不多。她说：“两者在疲劳和乳腺水肿方面无明显差异。”美容效果也是令人满意的。

加州Duarte希望综合性肿瘤中心癌症治疗计划项目成员、放射肿瘤学教授Nayana Vora医生说，这个最新的研究可以提供医生在给每一个乳腺癌患者做放疗计划时，可选择一个做好的治疗方法。

这只是一个短期的随访，她说，并指出可能会发生迟发的表面副反应。但是她指出美国以外的一个研究显示短程治疗后随访12年的结果和Chadha得研究一致。

Vora说：“目前美国有很少关于全乳放疗加瘤床加量的文献报道，他告诉我们病人完全可以接受短程放疗，但这会不会成为一个标准治疗，我不知道。”

但Vora仍给他的病人做经典的传统6周照射，除非病人因为交通运输问题或其他障碍不能耐受次治疗疗程。她说她正在考虑短程治疗。

在肿瘤学会议上，有另一项研究报告称，乳腺癌患者接受乳房切除术后再进行胸骨后淋巴结（内乳淋巴结）照射没有比不接受内乳淋巴结照射的获得更长的生存期。

这个研究评价了1334例1期或2期乳腺癌患者腋窝淋巴结转移的病人或原发肿瘤位于中心或内侧象限的病人，所有的病人接受胸壁照射和锁骨上照射，但一半接受了内乳淋巴结照射，而另一半未接受内乳淋巴结照射。

十年后两组间的生存差异非常小，没有接受额外加量的乳腺癌患者的十年生存率为60%，接受额外加量的乳腺癌患者的十年生存率为63%。

Vora解释说，绝大大部分放射肿瘤学家不愿照射内乳淋巴结，因为内乳淋巴结距离心脏太近。
2009-11-05 21:14
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hdbys 编辑于 2009-11-05 21:16
  • • 十年坎坷行医路，请问路在何方？

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