Clinical outcomes of fungating breast cancer treated with palliative radiotherapy

Chia, David; Tan, Ee Hong; Lu, Jiade J.; Soon, YY; Tiong, Eve; Cheo, Timothy; Lim, Keith; Tey, Jeremy; Tang, Johann I.; Choo, Bok Ai; Koh, Winston T. H.

doi:10.1007/s13566-016-0278-z

Cited by 7 publications

(10 citation statements)

References 7 publications

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“…16 While these results may loosely suggest a dose-response relationship, Chia and colleagues found no difference between a higher and lower mean BED in terms of duration of palliation or survival in a retrospective review of 35 patients with fungating breast cancer; however, we can expect a local response rate up to 90 % and a median local progression-free survival of 10 months, regardless of histology. 17 Our series of six patients provides further evidence on the significant role of orthovoltage radiation therapy alone or as an adjunct to linac-based treatment for patients with fungating locally advanced or metastatic breast cancer. Patients were carefully selected, and while this methodology may be unconventional and lacks highlevel evidence, our institutional experience found that it enabled treatment to be started immediately and was effective at rapidly relieving discharge or bleeding.…”

Section: Discussionmentioning

confidence: 64%

“…The goal is to apply a total dose of 70-75 Gy (BED) to the tumor itself, which is equal or slightly higher than other documented case reports. 13,15,17 Of course, one must account for limitations to the organs-at-risk as there is no accurate insight with kV into the actual dose received, especially to the heart. Therefore, we recommended checking; at least approximately, what volume of heart is in the irradiation field on a conventional simulator before treatment.…”

Section: Discussionmentioning

confidence: 99%

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Kilovoltage radiotherapy as a supportive treatment in locally advanced or metastatic breast cancer – a series of six case reports

Jovanović¹,

Aleksandar²,

Stojanović³

et al. 2023

IJRRT

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Kilovoltage (kV) radiotherapy, also called superficial radiotherapy (SXT) or orthovoltage radiotherapy (DXT), is a well-known and effective treatment option for non-melanoma skin cancer and some benign skin and musculoskeletal conditions. Given its surface dose delivery, its use in radiation oncology beyond superficial skin cancers is generally limited, but it has also been shown to be extremely useful for specific palliative applications. Here, we describe the characteristics of kilovoltage radiotherapy and report on six cases of locally advanced and/or metastatic breast cancer in which kilovoltage radiotherapy was used as the primary modality or as supportive treatment to linac-based radiotherapy to gain local tumor control and improve the patient’s quality of life.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Kilovoltage radiotherapy as a supportive treatment in locally advanced or metastatic breast cancer – a series of six case reports

Jovanović¹,

Aleksandar²,

Stojanović³

et al. 2023

IJRRT

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“…Table 1 shows the palliative responses and side effects from various breast-directed pRT. 9 , 10 , 11 , 12 , 13 Given the low α/β ratio (2-4) of breast cancer, 9 , 14 the biologic effective dose (BED) and equivalent dose in 2 Gy fraction (EQD2) were calculated with the α/β ratio of 3.3 for breast cancer and 3 for the breast tissue.…”

Section: Discussionmentioning

confidence: 99%

Breast-Directed Quad Shot Radiation Therapy for Effective Breast Symptoms Palliation Without Interrupting or Delaying Systemic Cancer Therapy Schedule in Patients With Neglected Breast Cancer

Kil¹,

Collins²,

Branton³

et al. 2023

Advances in Radiation Oncology

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“…19 Furthermore, women with LABC or inoperable local recurrence often suffer from a significantly reduced QOL due to local tumor-associated pain, bleeding, exulceration, or malodorous discharge. [9][10][11] Palliative RT plays an important role in symptom management and might become even more required as a response to the relative aging of the populations. 20,21 Still there is surprisingly scarce evidence regarding palliative RT in symptomatic LABC or locoregional recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…LC was 47.6% after 12 months with a median LC of 7.4 months, which is in line with previously reported LC rates. 9,28 Other studies reported a correlation between LC and the applied dose or the tumor volume. [29][30][31] Although we did observe a trend between LC and the irradiated tumor volume, this correlation was not significant.…”

Section: Discussionmentioning

confidence: 99%

Palliative Radiotherapy for Symptomatic Locally Advanced Breast Cancer

Hoeltgen

Meixner

Hoegen

et al. 2023

Technol Cancer Res Treat

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Objective: Women with locally advanced breast cancer (LABC) or inoperable local recurrence often suffer from a significantly reduced quality of life (QOL) due to local tumor-associated pain, bleeding, exulceration, or malodorous discharge. We aimed to further investigate the benefit of radiotherapy (RT) for symptom relief while weighing the side-effects. Materials and methods: Patients who received symptom-oriented RT for palliative therapy of their LABC or local recurrence in the Department of Radiation Oncology at Heidelberg University Hospital between 2012 and 2021 were recorded. Clinical, pathological, and therapeutic data were collected and the oncological and symptomatic responses as well as therapy-associated toxicities were analyzed. Results: We retrospectively identified 26 consecutive women who received palliative RT with a median total dose of 39 Gy or single dose of 3 Gy in 13 fractions due to (impending) exulceration, pain, local hemorrhage, and/or vascular or plexus compression. With a median follow-up of 6.5 months after initiation of RT, overall survival at 6 and 12 months was 60.0% and 31.7%, and local control was 75.0% and 47.6%, respectively. Radiation had to be discontinued in 4 patients due to oncological clinical deterioration or death. When completed as initially planned, symptom improvement was achieved in 95% and WHO level reduction of analgesics in 28.6% of patients. In 36% (16%) of patients, local RT had already been indicated >3 months (>6 months) before the actual start of RT, but was delayed or not initiated among others in favor of drug alternatives or systemic therapies. RT-associated toxicities included only low-grade side-effects (CTCAE I°-II°) with predominantly skin erythema and fatigue even in the context of re-RT. Conclusion: Palliative RT in symptomatic LABC or locoregional recurrence is an effective treatment option for controlling local symptoms with only mild toxicity. It may thus improve QOL and should be considered early in palliative patient care management.

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Clinical outcomes of fungating breast cancer treated with palliative radiotherapy

Cited by 7 publications

References 7 publications

Kilovoltage radiotherapy as a supportive treatment in locally advanced or metastatic breast cancer – a series of six case reports

Kilovoltage radiotherapy as a supportive treatment in locally advanced or metastatic breast cancer – a series of six case reports

Breast-Directed Quad Shot Radiation Therapy for Effective Breast Symptoms Palliation Without Interrupting or Delaying Systemic Cancer Therapy Schedule in Patients With Neglected Breast Cancer

Palliative Radiotherapy for Symptomatic Locally Advanced Breast Cancer

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