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KMID : 0378019770200020083
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New Medical Journal
1977 Volume.20 No. 2 p.83 ~ p.102
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Evaluation of Radiation Treatment Methods for Postmastectomy Breast Cancer
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崔慶姬/Choi, K.H.
秋成實/南正祐/崔炳肅/Chu, S.S./Nam, M.S./Choi, B.S.
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Abstract
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Routine postoperative radiation therapy has been widely employed to supplement the surgical -procedure. Following radical mastectomy, the volume to be irradiated will be the full thickness of the chest wall over an irregular area and the draining lymphatic chains including axillary, supraclavicular and internal mammary nodes.
The principal aim of radiotherapy is to deliver adequate dose of radiation to the tumor bearing tissue and at the same time to avoid excessive damage to the underlying normal tissue. The anatomy of the breast. chest wall and lymph node drainage areas make the satisfactory homogeneous high dose irradiation of the required volume extremely difficult to achieve and has led to the progressive development for better irradiation techniques.
In this article, authors have extensively reviewed and collected the various radiotherapy techniques which has been used since the days of conventional x-ray therapy from around 1930s up to the present time. They were divided into the seven representative methods according to the different energies of radiation. Their characteristics, and advantage and disadvantage were evaluated and compared in the physical and technical aspects. Clinical results including survivals, local recurrence, and complications were compared following a review of related articles.
Conventional orthovoltage radiation and cesium-137 therapy have been largely replaced with cobalt-60 and electron bean treatment. The most widely used methods at present time are tangential therapy using cobalt-60 and direct appositional treatment with the appropriate energies of electron beam. The high energy electron beam therapy which has been rapidly developed since 1960s produce slightly more skin reaction than cobalt-60, but it is mild in degree and have many
practical merits. They include technical simplicity, easy dose plan and calculation, small probability of error. and less radiation pneumonitis than cobalt-60. No sufficient clinical results are yet available for comparison of treatment effects between the two methods, however electron beam seems to be more suitable for the treatment of postmastectomy chest wall in breast cancer.
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