Abstract
According to the data for 2019, breast cancer occupies a leading position among malignant neoplasms in the female population in the Russian Federation.
Currently, there is an increase in the number of young breast cancer patients. In this regard, the requirements for the quality of life of patients, in particular the aesthetic results of special treatment, are increasing, which contributes to the introduction of methods of reconstructive surgery in oncomammology.
The two-stage installation of a silicone breast implant is the most common method of breast reconstruction in oncological practice, in which a tissue expander is installed in patients at the first stage after mastectomy, and at the second stage it is replaced with a permanent implant.
At the same time, the issue of radiotherapy in patients who have undergone the surgical stage of breast cancer treatment with reconstructive plastic surgery remains relevant to date. As is known, radiotherapy plays an important role in the combined and complex treatment of breast cancer, increasing, in general, locoregional control in operated patients. On the other hand, it may increase the risk of late complications of breast reconstruction, such as the development of capsular contractures and protrusions.
It should also be emphasized that at present, the impact of hypofractive radiotherapy regimes, which are the most promising in clinical development, primarily on endoprostheses in patients during two-stage reconstruction, remains insufficiently studied. This article presents a brief analysis of the physical and dosimetric planning of radiotherapy in patients with breast cancer after the installation of a tissue expander who were treated on the basis of the RNCRR.
References
Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2019. ISBN 978-5-85502-251-3.
Грушина Т.И., Ткаченко Г.А. Психологический дистресс у больных раком молочной железы после различных видов противоопухолевого лечения // Опухоли женской репродуктивной системы. 2016;12(1):56–62.
Солодкий, В.А. Шерстнева, Т.В. Меских Е.В. Реконструктивно-пластические операции при раке молочной железы в российской федерации и за рубежом (сравнительный анализ) // Клиническая медицина. 2018;13(3):132–137.
Abe O, Abe R, Enomoto K. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials // Lancet. 2005;366(9503):2087–2106.
Darby SC, Ewertz M, McGale P. et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer // N. Engl. J. Med. Massachussetts Medical Society, 2013;368(11):987–998.
Vasiljevic D, Arnold C, Neuman D. Occurrence of pneumonitis following radiotherapy of breast cancer — A prospective study // Strahlentherapie und Onkol. 2018;194(6):520–532.
Полушкин П.В., Паньшин Г.А., Измайлов Т.Р. Радиотерапия рака молочной железы у пациенток с установленным тканевым экспандером (краткий обзор литературы ) // Трудный пациент. 2020):44–50.
Ходорович О.С., Калинина-Масри А.А., Канахина Л.Б. и др. Реконструктивно пластические операции с использованием экспандера // Вестник Российского научного центра рентгенорадиологии. 2020;20(1):1–14.
Headon H, Kasem A, Mokbel K. Capsular contracture after breast augmentation: An update for clinical practice // Archives of Plastic Surgery. Korean Society of Plastic and Reconstructive Surgeons, 2015;42(5):532–543.
Anker CJ, Hymas RV. Kokeny KE et al. The effect of radiation on complication rates and patient satisfaction in breast reconstruction using temporary tissue expanders and permanent implants // Breast J. 2015;21(3):233–240.
Moni J, Graves-Ditman M, Cederna P et al. Dosimetry around metallic ports in tissue expanders in patients receiving postmastectomy radiation therapy: An ex vivo evaluation // Med. Dosim. 2004;29(1):49–54.
Trombetta DM, Cardoso SC, Facure A et al. Influence of the Presence of Tissue Expanders on Energy Deposition for Post-Mastectomy Radiotherapy // PLoS One. 2013;8(2).
Owen JR, Ashton A, Bliss JM et al. Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomised trial // Lancet Oncol. 2006;7(6):467–471.
Yarnold J, Ashton A, Homewood J et al. Fractionation sensitivity and dose response of late adverse effects in the breast after radiotherapy for early breast cancer: Long-term results of a randomised trial // Radiother. Oncol. 2005;75(1):9–17.
Gentile MS, Usman AA, Neuschler EI et al. Contouring guidelines for the axillary lymph nodes for the delivery of radiation therapy in breast cancer: Evaluation of the RTOG breast cancer atlas Presented in abstract form at the 55th Annual Meeting of the American Society for Radiation Oncology, Atl // Int. J. Radiat. Oncol. Biol. Phys. Elsevier Inc. 2015;93(2):257–265.
Nielsen MH, Berg M, Pedersen AN et al. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: National guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group // Acta Oncol. (Madr). 2013;52(4):703–710.
Bentzen SM, Constine LS, Deasy JO et al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): An Introduction to the Scientific Issues // Int. J. Radiat. Oncol. Biol. Phys. 2010;76(3):3–9.
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