유방암 및 부인암 환자의 방사선치료와 림프부종 발생

Radiotherapy is an important treatment that improves the local control rate of tumors and the survival rate of patients. However, radiotherapy causes fibrosis of lymph nodes and decreases in flow and formation of lymphatic vessels, which in combination with postoperative inflammatory reactions or lymph node dissection causes lymphedema. Radiotherapy for breast cancer has been shown to be a risk factor for lymphedema through several prospective trials. In particular, the incidence of lymphedema significantly increased when extensive field of regional lymph nodes, including level 1, 2 axillary lymph node were irradiated. For gynecological cancer, radiotherapy is also known to increase the incidence lymphedema, among which external beam radiotherapy showed a higher incidence of lymphedema than intracavitary irradiation. The relationship between radiotherapy and lymphedema is an ongoing area of research, and efforts such as small field regional lymph node irradiation, hypofractionation, and intensity modulated radiotherapy were applied to minimize lymphedema. Moreover, efforts to reduce the incidence of lymphedema will be needed through appropriate multidisciplinary discussions among oncologists.