ArticleJournal of contemporary brachytherapy2021
Unresectable bulky chest wall recurrent breast cancer controlled with CT-guided interstitial high-dose-rate brachytherapy and external beam radiotherapy with adjuvant hormonal therapy - case report.
Article in Journal of contemporary brachytherapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeBulky chest wall recurrence after mastectomy presents a therapeutic challenge because of high-dose of radiation required to control the disease, and its proximity to low-tolerance organs at risk. We report a case of successful computed tomography (CT)-guided high-dose-rate (HDR) salvage interstitial brachytherapy (ISBT) boost. MATERIAL AND
methodsA 70-year-old female initially presented with a tumor in right breast, and was treated with mastectomy and adjuvant chemotherapy, followed by hormonal therapy for 5 years without adjuvant radiotherapy. In 2018, 20 years after the initial treatment, she developed unresectable chest wall recurrence that measured 10.5 cm × 7.3 cm × 4.5 cm, with bone and parietal pleura invasion. Biopsy revealed invasive pleomorphic lobular carcinoma [estrogen receptor (ER)-positive, progesterone receptor (PR)-negative, HER2-negative]. There was no evidence of metastatic disease.
resultsThe patient underwent external beam radiotherapy (EBRT) plus ISBT. After EBRT of 50 Gy in 25 fractions was completed, CT-guided ISBT was performed as an outpatient treatment. HDR dose was 16 Gy delivered in 2 fractions with 2 implants. Dose was prescribed to gross tumor volume. ISBT plans were created using inverse planning simulated annealing (IPSA) algorithm. Gross tumor volume D
conclusionsCT-guided HDR ISBT boost can be a useful modality in individualizing treatment strategies for breast cancer patients with unresectable bulky chest wall recurrence.
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