Bolus electron conformal therapy for the treatment of recurrent inflammatory breast cancer: a case report
Bolus electron conformal therapy for the treatment of recurrent inflammatory breast cancer: a case report
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DOI：
10.1016/j.meddos.2011.07.004
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发表时间：
2012-06-01
影响因子：
1.2
通讯作者：
Perkins, George H.
中科院分区：
文献类型：
--
作者：
Kim, Michelle M.;Kudchadker, Rajat J.;Perkins, George H.
在以前接受过放射治疗的患者中，局部复发乳腺癌的治疗是具有挑战性的。通常需要特殊的技术来根除疾病并将再次治疗的风险降至最低。我们报告一位早期左乳乳癌患者发展为炎症性复发，需要使用电子适形放射治疗配合影像引导的治疗方法再次照射胸壁。患者为51岁女性，曾于1998年6月接受肿块切除、腋窝淋巴结清扫和辅助全乳房放射治疗。2009年3月，她出现在我们机构的活检证实的复发性炎症性癌，并接受了积极的多因素化疗和乳房切除术，留下了阳性的手术切缘。考虑到患者先前的放疗和不规则的胸壁解剖，团注电子适形疗法被用来治疗她的胸壁和引流淋巴管，同时保留了下面的软组织。治疗21个月后，患者仍然没有疾病的证据。我们的结果表明，团注电子适形治疗是一种可接受的、有效的放射治疗方法，用于因胸壁解剖不规则而手术后复发的乳腺癌患者。这种方法可以补充用于减少乳腺癌切除术后局部复发的标准技术。(C)2012年美国医学剂量师协会。
The treatment of locoregionally recurrent breast cancer in patients who have previously undergone radiation therapy is challenging. Special techniques are often required that both eradicate the disease and minimize the risks of retreatment. We report the case of a patient with an early-stage left breast cancer who developed inflammatory-type recurrence requiring re-irradiation of the chest wall using bolus electron conformal therapy with image-guided treatment delivery. The patient was a 51-year-old woman who had undergone lumpectomy, axillary lymph node dissection, and adjuvant whole-breast radiation therapy for a stage I left breast cancer in June 1998. In March 2009, she presented at our institution with biopsy-proven recurrent inflammatory carcinoma and was aggressively treated with multi-agent chemotherapy followed by mastectomy that left a positive surgical margin. Given the patient's prior irradiation and irregular chest wall anatomy, bolus electron conformal therapy was used to treat her chest wall and draining lymphatics while sparing the underlying soft tissue. The patient still had no evidence of disease 21 months after treatment. Our results indicate that bolus electron conformal therapy is an accessible, effective radiation treatment approach for recurrent breast cancer in patients with irregular chest wall anatomy as a result of surgery. This approach may complement standard techniques used to reduce locoregional recurrence in the postmastectomy setting. (C) 2012 American Association of Medical Dosimetrists.