El refuerzo de radioterapia después de cirugía conservadora en cáncer de mama localmente avanzado
Palabras clave:
Neoplasias de la mama, terapia combinada, terapia neoadyuvante, mastectomía segmental, radioterapia, literatura de revisión como asuntoResumen
En países en vías de desarrollo, el cáncer de mama se presenta en estados localmente avanzados en la mitad de los casos. El manejo de estas pacientes se hace a partir de la combinación de quimioterapia, cirugía y radioterapia. La quimioterapia neoadyuvante posibilita la cirugía conservadora con relativa frecuencia, aunque esta aproximación terapéutica no se considera todavía una práctica estándar. No hay recomendaciones claras acerca del uso del refuerzo con radioterapia en este escenario. Se realizó una búsqueda de literatura relevante en Medline. La mayoría de artículos correspondieron a series de casos. La supervivencia libre de recaída loco-regional entre pacientes tratadas con quimioterapia neoadyuvante, cirugía conservadora y radioterapia sobre campos tangenciales asociada a un refuerzo localizado sobre el lecho tumoral es buena. El refuerzo se administró de manera sistemática a todas las pacientes sin considerar factores pronósticos diferentes del estado localmente avanzado. Aunque la evidencia no es de primer nivel, permite recomendar el uso sistemático del refuerzo en pacientes con tumores localmente avanzados de mama tratados con cirugía conservadora.
Biografía del autor/a
Ricardo Cendales, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, Bogotá, Colombia.
Pontificia Universidad Javeriana. Bogotá, Colombia.
Rosalba Ospino, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, Bogotá, Colombia.
Felipe Torres, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, Bogotá, Colombia.
Martha Cotes, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, Bogotá, Colombia.
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