目标:连接血管疾病(CVD),包括硬皮病,据报道,对于一些研究人员来说,这是放射治疗的相对禁忌症,对于另一些研究人员来说,是绝对禁忌症。我们研究的目的是在现有的国际文献中增加四例新病例,并确定已手术治疗早期乳腺癌的硬皮病女性是否可以接受术后放疗,而不会出现严重的早期和晚期并发症。
方法:从1998年5月至2010年11月,我们对4例先前患有硬皮病的早期乳腺癌患者进行了照射;保守手术后,我们对整个乳房进行了50.4Gy总剂量的全乳房术后放疗,并对肿瘤床进行了9Gy的增强。我们回顾了所有四名患者的记录,并使用急性放射发病率评分标准(放射治疗肿瘤学组[RTOG],美国放射学院,费城,PA)和晚期辐射发病率评分方案(欧洲癌症研究和治疗组织[EORTC],布鲁塞尔,比利时和RTOG)。
结果:经过105个月(范围12-155个月)的中位随访,皮肤的早期和晚期毒性,皮下组织,肺,心脏是可以接受的,并且完全符合国际文献报道的内容。
结论:这项研究符合全球经验,这表明硬皮病和乳腺癌患者必须由多学科肿瘤委员会讨论才能制定个性化的治疗策略。在某些情况下,可以建议将放射治疗作为术后治疗选择。
OBJECTIVE: Connective vascular diseases (CVD), including scleroderma, are reported to represent for some researchers a relative contraindication and for others absolute contraindication for radiotherapy. The purpose of our study is to add four new cases to the existing body of international literature and to determine whether women with pre-existing scleroderma who have been surgically treated for early breast cancer could undergo postsurgical radiotherapy without serious early and late complications.
METHODS: From May 1998 to November 2010, we irradiated for early breast cancer four patients suffering from pre-existing scleroderma; after conservative surgery, we performed whole breast postoperative radiotherapy of 50.4 Gy total dose to the whole breast plus a 9 Gy boost to the tumor bed. We reviewed the records of all four patients and evaluated the early and late reactions using acute radiation morbidity scoring criteria (Radiation Therapy Oncology Group [RTOG], American College of Radiology, Philadelphia, PA) and late radiation morbidity scoring scheme (European Organisation for Research and Treatment of Cancer [EORTC], Brussels, Belgium and RTOG).
RESULTS: After a median follow-up of 105 months (range 12-155 months) the early and late toxicity concerning the skin, the subcutaneous tissues, the lungs, and the heart have been acceptable and are in full accordance with what have been reported in international literature.
CONCLUSIONS: This study matches global experience, which shows that patients with scleroderma and breast cancer must be discussed by the multidisciplinary tumor board in order for a personalized treatment strategy to be formulated. Radiation therapy can be proposed as a postsurgical therapeutic option in selected cases.