Radiation Management for Breast Cancer After Neoadjuvant Therapy

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-09-22 DOI:10.1007/s12609-023-00506-1

Benjin D Facer, Ton Wang, Christina Weed, Ashley Pariser, Mathew Cherian, Kai C Johnson, Dionisia Quiroga, Daniel Stover, Samilia Obeng-Gyasi, Doreen Agnese, Bridget A Oppong, Sharad Goyal, Therese Andraos, Sasha Beyer, Sachin R Jhawar

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Abstract

Abstract Purpose of Review Neoadjuvant chemotherapy (NAC) utilization is an important part of breast cancer therapy. Recent advances call into question the optimal role of radiotherapy after NAC, as many radiation studies were performed without NAC. This review was conducted to understand the current data, outstanding questions and ongoing trials related to radiotherapy after NAC. Recent Findings Response to NAC is associated with promising clinical outcomes, particularly in triple-negative and HER2+ breast cancer. Retrospective data suggest that modification of radiotherapy based on tumor response to NAC may be appropriate, though caution is advised without prospective randomized evidence. NSABP B-51 and Alliance A011202 will investigate the management of nodal disease in this setting. Future trials will examine the optimal sequencing of treatments. Summary The personalization of adjuvant radiotherapy based on response to neoadjuvant chemotherapy is an attractive goal that is currently being evaluated in multiple clinical trials, including NSABP B-51.

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乳腺癌新辅助治疗后的放疗管理

新辅助化疗(NAC)的应用是乳腺癌治疗的重要组成部分。最近的进展对NAC后放疗的最佳作用提出了质疑，因为许多放射研究是在没有NAC的情况下进行的。本综述旨在了解NAC术后放疗相关的现有数据、悬而未决的问题和正在进行的试验。对NAC的反应与有希望的临床结果相关，特别是在三阴性和HER2+乳腺癌中。回顾性数据表明，根据肿瘤对NAC的反应调整放疗可能是适当的，但在没有前瞻性随机证据的情况下，建议谨慎。NSABP B-51和Alliance A011202将研究这种情况下淋巴结疾病的管理。未来的试验将检验最佳的治疗顺序。基于对新辅助化疗反应的个性化辅助放疗是一个有吸引力的目标，目前正在多个临床试验中进行评估，包括NSABP B-51。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.