open access

Vol 25, No 4 (2020)
Case reports
Published online: 2020-07-01
Submitted: 2019-03-31
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Adult Onset Still's Disease and Radiotherapy treatment for breast cancer: Case report about management of this rare association and literature review

Fabio Marazzi, Valeria Masiello, Gianluca Franceschini, Silvia Bosello, Francesca Moschella, Daniela Smaniotto, Stefano Luzi, Antonino Mulé, Maria Antonietta Gambacorta, Elisa Gremese, Riccardo Masetti, Vincenzo Valentini
DOI: 10.1016/j.rpor.2020.03.013
·
Rep Pract Oncol Radiother 2020;25(4):527-532.

open access

Vol 25, No 4 (2020)
Case reports
Published online: 2020-07-01
Submitted: 2019-03-31

Abstract

Aim

This manuscript focuses on the first experience in literature of a patient with a complicated Adult Onset Still's Disease-related heart failure who thereafter underwent adjuvant radiotherapy for left breast cancer.

Background

AOSD is a rare autoimmune inflammation-related disease, in which life-threatening pulmonary and cardiac complications can occur. In literature, AOSD is often associated with cancer, as paraneoplastic syndrome, but there are few data about primary AOSD and management of oncological therapies.

Materials and Methods

A patient who needed adjuvant breast cancer radiotherapy underwent tumour board evaluation to define feasibility of an RT in a patient with of a history of a heart life-threatening complication 2 years before AOSD. Results of the review were discussed by a multidisciplinary panel of experts that chose the type of surgery, radiotherapy and monitoring of patient.

Results

Literature review confirmed association of AOSD with BC in some pts and uniqueness of this treatment management experience. Patient underwent RT according to schedule of 40.05/2.67Gy/fx on residual left breast and 10/2Gy/fx on tumour bed with the gating technique. The panel chose to keep immunosuppressive therapy with anakinra. No complications were observed at clinical, ECG and laboratory examinations. Maximum toxicity was G2 skin. At first follow up AOSD signs of flare were negative.

Conclusion

In conclusion, when oncological treatments, especially radiotherapy, are mandatory for AOSD pts, multidisciplinary management and tailored monitoring are necessary to avoid acute adverse effects and allow pts to complete therapies.

Abstract

Aim

This manuscript focuses on the first experience in literature of a patient with a complicated Adult Onset Still's Disease-related heart failure who thereafter underwent adjuvant radiotherapy for left breast cancer.

Background

AOSD is a rare autoimmune inflammation-related disease, in which life-threatening pulmonary and cardiac complications can occur. In literature, AOSD is often associated with cancer, as paraneoplastic syndrome, but there are few data about primary AOSD and management of oncological therapies.

Materials and Methods

A patient who needed adjuvant breast cancer radiotherapy underwent tumour board evaluation to define feasibility of an RT in a patient with of a history of a heart life-threatening complication 2 years before AOSD. Results of the review were discussed by a multidisciplinary panel of experts that chose the type of surgery, radiotherapy and monitoring of patient.

Results

Literature review confirmed association of AOSD with BC in some pts and uniqueness of this treatment management experience. Patient underwent RT according to schedule of 40.05/2.67Gy/fx on residual left breast and 10/2Gy/fx on tumour bed with the gating technique. The panel chose to keep immunosuppressive therapy with anakinra. No complications were observed at clinical, ECG and laboratory examinations. Maximum toxicity was G2 skin. At first follow up AOSD signs of flare were negative.

Conclusion

In conclusion, when oncological treatments, especially radiotherapy, are mandatory for AOSD pts, multidisciplinary management and tailored monitoring are necessary to avoid acute adverse effects and allow pts to complete therapies.

Get Citation

Keywords

Adult Onset Still' s Disease; Radiotherapy; Gating technique application; Autoimmune disease

About this article
Title

Adult Onset Still's Disease and Radiotherapy treatment for breast cancer: Case report about management of this rare association and literature review

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 4 (2020)

Pages

527-532

Published online

2020-07-01

DOI

10.1016/j.rpor.2020.03.013

Bibliographic record

Rep Pract Oncol Radiother 2020;25(4):527-532.

Keywords

Adult Onset Still's Disease
Radiotherapy
Gating technique application
Autoimmune disease

Authors

Fabio Marazzi
Valeria Masiello
Gianluca Franceschini
Silvia Bosello
Francesca Moschella
Daniela Smaniotto
Stefano Luzi
Antonino Mulé
Maria Antonietta Gambacorta
Elisa Gremese
Riccardo Masetti
Vincenzo Valentini

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