Successful palliative hypofractionated radiotherapy with superficial hyperthermia for heavily pretreated cutaneous breast cancer lesions.

backgroundHypofractionated radiotherapy has been successfully shown to reduce pain and skin lesion bleeding. In previously irradiated areas, the effect of hypofractionated radiotherapy (weekly 4 Gy radiotherapy to a total dose of 20 Gy) can be enhanced by hyperthermia: increasing temperatures in target areas up to 43 °C. Superficial hyperthermia in combination with radiotherapy is a proven and widely applied treatment for recurrent breast cancer and malignant melanoma. Literature on the use of radiotherapy to cause hemostasis of the skin is available; however, the role of hyperthermia in combination with radiotherapy for this indication is not yet described. SHORT COMMUNICATION: We present a 72-year old woman with a history of breast cancer with painful and bleeding cutaneous metastases in the right upper arm and right breast which had a large impact on her quality of life. The metastases progressed under T‑deruxtecan treatment, and she was referred for re-irradiation to control the bleeding skin. Hyperthermia was added as a tumor-selective radiosensitizer to the radiotherapy fractions to enhance irradiation. The main treatment goal was to reduce bleeding and itching of the cutaneous lesions. The patient was treated once a week with hyperthermia immediately followed by 4 Gy radiotherapy fractions for 5 consecutive weeks. Bleeding was already decreased during the treatment series and the skin healed within 4 weeks after therapy.

conclusionTreatment with 5 × 4 Gy radiotherapy combined with hyperthermia sessions was a successful palliative therapy for bleeding cutaneous metastases. The treatment schedule was well-tolerated and the skin fully recovered within 1 month.