Intensity Modulated Proton Therapy for Re-Irradiation of Bulky Loco-Regional Recurrent Breast Cancer: A Case Report  

作　　者：Bosco Giap Thorsten Ostrander Angie Waldinger Fantine Giap Huan Giap Bosco Giap;Thorsten Ostrander;Angie Waldinger;Fantine Giap;Huan Giap(University of Texas Health Science Center, College Station, TX, USA;Scripps Clinic, La Jolla, CA, USA;University of Florida, Gainesville, FL, USA;University of Miami Sylvester Cancer Center, Miami, FL, USA)

机构地区：[1]University of Texas Health Science Center, College Station, TX, USA [2]Scripps Clinic, La Jolla, CA, USA [3]University of Florida, Gainesville, FL, USA [4]University of Miami Sylvester Cancer Center, Miami, FL, USA

出　　处：《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》2021年第1期1-11,共11页医学物理学、临床工程、放射肿瘤学（英文）

摘　　要：Patients with recurrent breast cancer to chest wall, who had previous irradiation, are difficult to manage and have limited options. Several reports described the use of photon therapy, hyperthermia, and brachytherapy. This is a case report of a 72-year-old female with Stage IIIA (pT3N1M0) invasive ductal carcinoma of the right breast status post modified radical mastectomy. The patient developed recurrence to the chest wall and one internal mammary lymph node one year later. She received 3-D conformal photon radiation therapy for this recurrence. Two years later, she had progression of the recurrence at the right chest wall and axillary and internal mammary lymph nodes. She was treated with intensity modulated proton therapy (IMPT) for a total of 6600 cGy in 33 fractions. However, four months later, she was found to have biopsy-proven isolated metastatic disease at her right bicep, which was again treated with IMPT for a dose of 6000 cGy in 20 fractions. Proton beam therapy was used in this case to spare dose to the brachial plexus, heart and lung while optimally irradiating the recurrent tumors. At last follow up, the patient is alive and has been disease free for 39 months. This report describes the technique and dosimetry for this unique case, which also reviewed recent series of re-irradiation using proton beam.Patients with recurrent breast cancer to chest wall, who had previous irradiation, are difficult to manage and have limited options. Several reports described the use of photon therapy, hyperthermia, and brachytherapy. This is a case report of a 72-year-old female with Stage IIIA (pT3N1M0) invasive ductal carcinoma of the right breast status post modified radical mastectomy. The patient developed recurrence to the chest wall and one internal mammary lymph node one year later. She received 3-D conformal photon radiation therapy for this recurrence. Two years later, she had progression of the recurrence at the right chest wall and axillary and internal mammary lymph nodes. She was treated with intensity modulated proton therapy (IMPT) for a total of 6600 cGy in 33 fractions. However, four months later, she was found to have biopsy-proven isolated metastatic disease at her right bicep, which was again treated with IMPT for a dose of 6000 cGy in 20 fractions. Proton beam therapy was used in this case to spare dose to the brachial plexus, heart and lung while optimally irradiating the recurrent tumors. At last follow up, the patient is alive and has been disease free for 39 months. This report describes the technique and dosimetry for this unique case, which also reviewed recent series of re-irradiation using proton beam.

关 键 词：Proton Therapy Breast Cancer RE-IRRADIATION Intensity Modulated Proton Therapy 

分 类 号：R73[医药卫生—肿瘤]