Strahlentherapie beim Mammakarzinom – State of the Art

Die Bestrahlung einer Brustkrebserkrankung hat eine lange Tradition. Eine entsprechende Behandlung wurde bereits im Jahre 1907 durch Georges Chicotot in Paris beschrieben [1]. Noch heute stellt die Strahlentherapie einen wesentlichen Bestandteil moderner multimodaler Therapiekonzepte beim Mammakarzinom und dessen Vorstufen dar. Durch kontinuierliche Verbesserungen der technischen Möglichkeiten ist die Strahlentherapie heutzutage sehr zielgenau und in der Regel nebenwirkungsarm durchzuführen. Ihre Rolle in den verschiedenen Erkrankungssituationen konnte durch zahlreiche Studien mittlerweile gut charakterisiert werden.

Postoperatively irradiation will be applied in the situation of DCIS after conservative resection and risk adapted also after mastectomy. Today, irradiation is an integral component of the total therapy of mamma carcinoma. During the last years new technique developments have emerged and therefore irradiation has become more efficient with minor side effects. The recurrence rate and the overall survival rate will be improved both after conservative resection and mastectomy. The lymph areas should be irradiated only in the case of higher risk. The beginning of irradiation should be in the range between 6 and 8 weeks after surgery. But because chemotherapy is interposed in most cases, irradiation will start after a lot of months after surgery and therefore the results could be compromised.

An alternative to this problem could be seen in the so-called intraoperative or accelerated radiotherapy of the mamma which can be realized within one week or one treatment day. Actually, results concerning recurrence rate and overall survival are unclear.

Key words

irradiation - mamma carcinoma - side effects - new techniques - intraoperative therapy - accelerated radiotherapy of the mamma

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