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brusterhaltende Therapie des Mamma - Karzinoms
Indikation(1) Eine lokale Dosisaufsättigung (Boost-Bestrahlung) des Tumorbettes senkt die lokale Rezidivrate in der Brust Ein signifikanter Überlebensvorteil der Boostbestrahlung wurde bisher nicht nachgewiesen. Die Boostbestrahlung soll durchgeführt werden bei (AGO Mamma 2023):
  • < 50 Jahre
  • G3
  • HER2-positiv
  • TNBC
  • EIC, extensive intraductal component
Lyon trial Romestaing P, Lehingue Y, Carrie C, et al.
Role of a 10-Gy boost in the conservative treatment of early breast cancer: Results of a randomized clinical trial in Lyon, France.
J Clin Oncol. 1997;15:963–968.

Polgar C, Fodor J, Orosz Z, et al. 
Electron and high-dose-rate brachytherapy boost in the conservative treatment of stage I-II breast cancer: First results of the randomized Budapest boost trial.
Strahlenther Onkol. 2002;178:615–623.
EORTC 22881-10882 Bartelink H, Horiot JC, Poortmans PM, et al.
Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial.
J Clin Oncol. 2007;25:3259–3265. 613. Antonini, N., et al., Effect of age and radiation dose on local control after breast conserving treatment: EORTC trial 22881-10882. Radiother Oncol, 2007. 82(3): p. 265-71. 614. Bartelink, H., et al., Whole-breast irradiation with or without a boost for patients treated with breast-conserving surgery for early breast cancer: 20-year follow-up of a randomised phase 3 trial. Lancet Oncol, 2015. 16(1): p. 47-56. 615. Vrieling, C., et al., Prognostic Factors for Local Control in Breast Cancer After Long-term Follow-up in the EORTC Boost vs No Boost Trial: A Randomized Clinical Trial. JAMA Oncol, 2017. 3(1): p. 42- 48.
integrierter Boost Sedlmayer F., Sautter Bihl ML., Budach W. et al.: Is the simultaneously integrated boost (SIB) technique for early breast cancer ready to be adopted for routine adjuvant radiotherapy?: Statement of the German and the Austrian Societies of Radiooncology (DEGRO/ÖGRO). Strahlenther Onkol 2013, 189: 193–196. Bantema-Joppe EJ., Schilstra C., de Bock GH. et al. (2012): Simultaneous integrated boost irradiation after breast-conserving surgery: physician-rated toxicity and cosmetic outcome at 30 months' follow-up. Int J Radiat Oncol Biol Phys 83:e471–7. Hurkmans CW., Dijckmans I., Reijnen M. et al. (2012): Adaptive radiation therapy for breast IMRTsimultaneously integrated boost: three-year clinical experience. Radiother Oncol 103:183–7
Quellen 1.) Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF):
S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Mammakarzinoms, Version 4.1, 2018
AWMF Registernummer: 032-045OL
http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom/
(abgerufen am: 18.11.19)

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 Strahlentherapie des Mamma - Karzinoms
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