High-dose adaptive radiotherapy for inoperable breast cancer with skin invasion after failure of chemotherapy
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Abstract
Introduction. In patients with inoperable breast cancer and skin invasion, the failure of chemotherapy results in symptoms such as bleeding, discharge, and offensive odor, significantly impacting the patient’s quality of life. The purpose of this study was to investigate the feasibility and efficacy of high-dose adaptive radiotherapy for inoperable breast cancer with skin invasion after chemotherapy failure.
Material and methods. In this retrospective study, six consecutive patients diagnosed with inoperable breast cancer, characterized by regional lymph node metastases and, in four cases, oligometastases, were evaluated. All patients showed skin invasion after the failure of chemotherapy. We conducted planned adaptive high-dose radiotherapy using helical tomotherapy to the whole breast and metastatic regional lymph node areas. Subsequently, we administered boost adaptive radiotherapy to the breast cancer and the metastatic lymph nodes. The total doses delivered to the breast cancer and metastatic lymph nodes ranged from 66 to 75 Gy and 60 to 70 Gy, respectively.
Results. After a median follow-up of 18 months, the rates of 2-year local progression-free survival, disease-specific survival, and overall survival were 100%, 62.5%, and 50.0%, respectively. Grade 1 dermatitis was observed in five patients, whereas one patient experienced grade 2 skin edema.
Conclusions. High-dose adaptive radiotherapy may be a feasible and effective treatment option for patients with advanced breast cancer with skin invasion who have failed chemotherapy.
Keywords: breast neoplasmsradiotherapypalliative therapy
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