乳腺癌脑转移放疗联合系统治疗研究进展

Recent advances in radiotherapy combined with systemic treatment for breast cancer brain metastasis

乳腺癌脑转移瘤是第二常见的脑转移肿瘤,常表现为多发脑转移。放疗是乳腺癌脑转移瘤重要的局部治疗手段,包括立体定向放疗、全脑放疗联合同步加量、全脑放疗(适形全脑放疗和海马保护性全脑放疗)等放疗方式。同时,乳腺癌脑转移瘤的系统治疗技术进展迅速,在延缓脑转移瘤出现、维持无症状或无进展脑转移、延缓初始或挽救性的局部治疗方面展现了积极作用。近年来部分研究表明,与单独放疗相比,乳腺癌脑转移瘤的放疗联合系统治疗有更好的应用前景。本文在回顾乳腺癌脑转移瘤的放疗进展、系统治疗在乳腺癌脑转移瘤中的作用、放疗联合系统治疗的临床研究的基础上进行总结探讨,希望为该领域的临床研究提供一定的参考。

Breast cancer brain metastasis(BCBM)is the second most common brain metastasis cancer,which is usually characterized by multiple lesions.Radiotherapy is an important local treatment for BCBM,which includes stereotactic radiotherapy,whole brain radiotherapy(WBRT)combined with simultaneous integrated boost and WBRT(such as conformal WBRT and hippocampal avoidance-WBRT).Meanwhile,systemic treatment of BCBM has progressed rapidly,showing a positive effect in delaying the incidence of brain metastases,maintaining asymptomatic or unprogressive brain metastases,and delaying initial or salvage local treatments.In recent years,some studies have shown that radiotherapy combined with systemic treatment for BCBM has better application prospect compared with radiotherapy alone.In this article,the radiotherapy progress of brain metastases,the role of systemic therapy in BCBM,and the clinical research of radiotherapy combined with systemic therapy were reviewed,aiming to provide some reference for clinical research in this field.