جستجوی مقالات مرتبط با کلیدواژه « reirradiation » در نشریات گروه « پزشکی »

Treatment of breast cancer (BC) remains a constant and rapidly evolving issue for multidisciplinary breast cancer teams. Considering the emerging understanding and advances in the biological course of this disease, new trends in radiotherapy fractionation, systemic therapies, and oncoplastic surgical techniques are revolutionizing adjuvant treatment approaches to BC. Novel challenges are questioning the integration of adjuvant radiotherapy (ART) into the real-world clinical setting.

PubMed literature search was conducted in order to extract data supporting the role of new trends in breast cancer adjuvant approach according to rising issues in the multidisciplinary team discussion such as sequencing with chemotherapy (CT) plus whole breast hypofractionated radiotherapy (HF-WBRT); the role of ART after neoadjuvant CT (NACT) followed by breast conservative surgery (BCS) in early BC achieving pathological complete remission (pCR); and the integration of ART in immediate autologous breast oncoplastic reconstruction after mastectomy (a-IBR). Furthermore, there are still several concerns about toxicity with adjuvant trastuzumab emtansine (T-DM1) or breast re-irradiation after BCS relapse in long-term survivors refusing mastectomy.

Among 40 hits, only 12 studies answered these issues. Many of them were retrospective studies. Less than 500 patients met the criteria for these issues and several conclusions were found exhaustive.

Few issues seem to have a literature solution, while there are still open questions in regard to these new trends. Novel strategies through prospective or randomized studies and new consensus guidelines are required.

We report a case of a metastatic breast cancer woman undergoing therapy with fulvestrant and palbociclib that was successfully treated with thoracic stereotactic ablative radiation therapy (SABR) for a hilar lymph node metastasis.

The patient began the radiation treatment in the week off of the palbociclib and reported no acute toxicity. The CT scan showed acute pneumonia 60 days after RT although the patient reported no symptomatology. In addition, the subsequent PET/TC scan performed six months after RT exhibited a complete response of the irradiated lesion.

The use of SABR in patients undergoing cyclin inhibitors appears to be potentially effective although the association must be further studied to investigate the toxicities.