背景:乳腺癌局部复发对临床医生来说是一个具有挑战性的问题。先前照射区域中不可切除的复发性雌激素受体阳性(ER)乳腺癌的治疗选择有限。一些研究表明,氟维司群与放射治疗一起使用可能会增加体外放射敏感性,还没有体内报告。
■这里,我们提供了一例病例报告,并对氟维司群联合放疗治疗不可切除的局部复发性ER+乳腺癌进行了叙述性回顾.患者于2015年接受改良根治术,辅助化疗,放射治疗,依西美坦随访至2018年11月,复发于胸骨累及的乳内淋巴结.
方法:最终诊断为乳腺癌内乳淋巴结转移,胸骨累及。
方法:诊断后,在多学科小组下,提出了同时使用氟维司群和再照射作为姑息治疗。
结果:临床反应良好,使放射治疗的治愈机会达到60Gy的总剂量。计算机断层扫描显示没有残留肿瘤的证据。
结论:据我们所知,这是第一份关于氟维司群联合再放疗治疗不可切除的局部复发性ER+乳腺癌的报告.由于没有观察到严重的不良事件,这种策略可能是一种合适的“局部区域抢救疗法”,以进一步减少肿瘤进展甚至达到疗效。在随机临床试验中对这种治疗策略的研究是必要的,以进一步评估其安全性和有效性。
BACKGROUND: Locoregional recurrence of breast cancer is a challenging issue for clinicians. Treatment options for unresectable recurrent estrogen receptor positive (ER+) breast cancer in previously irradiated area are limited. Some studies showed concomitant fulvestrant with radiation therapy might increase radiosensitivity compared with radiation alone in vitro, no in vivo
reports yet.
UNASSIGNED: Here, we present a
case report and make a narrative review of concomitant fulvestrant with radiation therapy for unresectable locoregional recurrent ER+ breast cancer. The patient was treated with modified radical mastectomy in 2015, adjuvant chemotherapy, radiotherapy, followed by exemestane until November 2018, relapsed in internal mammary lymph nodes with sternum involved.
METHODS: The final diagnosis was breast cancer internal mammary lymph nodes metastasis with sternum involved.
METHODS: After diagnosis was made, concurrent fulvestrant with reirradiation as a palliative treatment were proposed under multiple disciplinary team.
RESULTS: There was a good clinical response, enabling curative chance with radiation therapy to a total dose of 60 Gy. Computed tomography scan revealed no evidence of residual tumor.
CONCLUSIONS: As far as we know, this is the first report concerning concomitant fulvestrant with reirradiation for unresectable locoregional recurrent ER+ breast cancer. Since no severe adverse events were observed, this strategy could be a suitable \"loco-regional rescue therapy\" to further reduce tumor progression or even reach a curative effect. Studies of this treatment strategy in randomized clinical trials are warranted to further assess its safety and effectiveness.