open access

Vol 11, No 5 (2015)
Case report
Published online: 2016-02-17
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Radiation-induced myelopathy after hypofractionated radiotherapy in women with spinal metastases from breast cancer — a case report

Magdalena Szymanik, Patryk Domarecki, Jacek Rutkowski, Krystyna Serkies
Oncol Clin Pract 2015;11(5):292-294.

open access

Vol 11, No 5 (2015)
CASE REPORT
Published online: 2016-02-17

Abstract

Hypofractionated radiotherapy, with a single dose of 8 Gy or 20 Gy given in 4–5 fractions, remains a standard treatment of bone metastasis, including spine lesions. Hypofractionated radiotherapy is also used during re-irradiation. These schedules are associated with an increased risk of severe complications, and their differentiation from local tumour progression can be difficult. We describe a 55-year-old female with breast cancer, who underwent palliative radiotherapy with a dose of 20 Gy in four fractions to the Th6–Th10 spine levels. After four months the patient was referred for re-irradiation due to progression of neurological symptoms. MRI examination suggested local tumour progression. Due to rapid deterioration she did not receive re-irradiation, and died due to systemic fungal infection. Autopsy revealed extensive radiation myelopathy in previously irradiated thoracic spine, without the presence of cancer at the site.

Abstract

Hypofractionated radiotherapy, with a single dose of 8 Gy or 20 Gy given in 4–5 fractions, remains a standard treatment of bone metastasis, including spine lesions. Hypofractionated radiotherapy is also used during re-irradiation. These schedules are associated with an increased risk of severe complications, and their differentiation from local tumour progression can be difficult. We describe a 55-year-old female with breast cancer, who underwent palliative radiotherapy with a dose of 20 Gy in four fractions to the Th6–Th10 spine levels. After four months the patient was referred for re-irradiation due to progression of neurological symptoms. MRI examination suggested local tumour progression. Due to rapid deterioration she did not receive re-irradiation, and died due to systemic fungal infection. Autopsy revealed extensive radiation myelopathy in previously irradiated thoracic spine, without the presence of cancer at the site.

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Keywords

breast cancer, bone metastases, hypofractionated radiotherapy, re-irradiation

About this article
Title

Radiation-induced myelopathy after hypofractionated radiotherapy in women with spinal metastases from breast cancer — a case report

Journal

Oncology in Clinical Practice

Issue

Vol 11, No 5 (2015)

Article type

Case report

Pages

292-294

Published online

2016-02-17

Bibliographic record

Oncol Clin Pract 2015;11(5):292-294.

Keywords

breast cancer
bone metastases
hypofractionated radiotherapy
re-irradiation

Authors

Magdalena Szymanik
Patryk Domarecki
Jacek Rutkowski
Krystyna Serkies

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