The Choice of Radiation Therapy Technology for Synchronous Primary Disseminated Breast Cancer
https://doi.org/10.37174/2587-7593-2023-6-2-85-94
Abstract
Radiation therapy of the primary tumor can be a stage of treatment of patients with initial IV stage breast cancer, being delievered out not only in purpose of decreasing symptom’s severity, but with an increase of progression-free survival.
Modern technologies of radiation therapy, including intensity-modulated radiotherapy and radiation therapy with deep inspiration under the control of breathing (Respiratory Gating), can significantly reduce dose to risk organs and ensure a homogeneous isodose distribution in the irradiated area, which is especially important in patients receiving systemic treatment, which in itself has clinically significant cardio- and pulmonotoxicity.
The presented clinical case demonstrates the possibility of dose reduction to organs at risk with usage of modern technologies of conformal radiation therapy.
About the Authors
V. V. GlebovskayaRussian Federation
24 Kashirskoye Shosse, Moscow, 1154788
E. V. Timoshkina
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
O. P. Trofimova
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
M. V. Chernykh
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
T. A. Kryilova
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
T. N. Borisova
Russian Federation
86 Enthusiasts Shosse, Moscow, 111123
A. V. Nazarenko
Russian Federation
86 Enthusiasts Shosse, Moscow, 111123
S. B. Alieva
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
D. S. Romanov
Russian Federation
2с4 st. Buda, Moscow, 121128
I. P. Ganyshina
Russian Federation
24 Kashirskoye Shosse, Moscow, 1154788
References
1. Malignant neoplasms in Russia in 2020 (morbidity and mortality) Moscow. 2021 (In Russian).
2. State of Cancer Care in Russia in 2021 ed. by AD Kaprin, VV Starin, AO Shakhzadova. Starinsky, A.O. Shakhzadova. Moscow, 2022. 239 p. (In Russian).
3. Gradishar WJ, Moran MS, Abraham J, et al. Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022 Jun;20(6):691- 722. DOI: 10.6004/jnccn.2022.0030.
4. AOR clinical guideline of breast cancer treatment, 2021. (In Russian).
5. Pons-Tostivint E, Alouani E, Kirova Y, et al. Is there a role for locoregional treatment of the primary tumor in de novo metastatic breast cancer in the era of tailored therapies?: Evidences, unresolved questions and a practical algorithm. Crit Rev Oncol Hematol. 2021 Jan;157:103146. DOI: 10.1016/j.critrevonc.2020.103146.
6. Babiera GV, Rao R, Feng L, et al. Eծect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol. 2006;13(6):776-82. DOI: 10.1245/ASO.2006.03.033
7. Pons-Tostivint E, Kirova Y, Lusque A, et al. Radiation therapy to the primary tumor for de novo metastatic breast cancer and overall survival in a retrospective multicenter cohort analysis. Radiother Oncol. 2020 Apr;145:109-16. DOI: 10.1016/j.radonc.2019.12.019.
8. Le Scodan R, Stevens D, Brain E, et al. Breast cancer with synchronous metastases: survival impact of exclusive locoregional radiotherapy. J Clin Oncol. 2009 Mar 20;27(9):1375-81. DOI: 10.1200/JCO.2008.19.5396.
9. Poortmans PM. Hypofractionated radiation therapy regimens in breast cancer patients: current trends. Proceedings of the Russco Forum, Breast Cancer, 2021.
10. Cardoso F, Kyriakides S, Ohno S, et al. ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo. org. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up҉. Ann Oncol. 2019 Aug 1;30(8):1194-220. DOI: 10.1093/annonc/mdz173.
11. Xie Y, Bourgeois D, Guo B, Zhang R. Postmastectomy radiotherapy for leչ-sided breast cancer patients: Comparison of advanced techniques. Med Dosim. 2020 Spring;45(1):34-40. DOI: 10.1016/j.meddos.2019.04.005.
12. Narasimhulu BC, Valiyaveettil D, Joseph D, et al. Synchronous bilateral breast cancer patients treated with hypofractionated bilateral breast irradiation: A dosimetric and clinical study. J Cancer Res Ther. 2020 OctDec;16(6):1309-13. DOI: 10.4103/jcrt.JCRTѳ241ѳ20.
13. Marks LB, Yorke ED, Jackson A, et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S10-9. DOI: 10.1016/j.ijrobp.2009.07.1754.
Review
For citations:
Glebovskaya V.V., Timoshkina E.V., Trofimova O.P., Chernykh M.V., Kryilova T.A., Borisova T.N., Nazarenko A.V., Alieva S.B., Romanov D.S., Ganyshina I.P. The Choice of Radiation Therapy Technology for Synchronous Primary Disseminated Breast Cancer. Journal of oncology: diagnostic radiology and radiotherapy. 2023;6(2):85-94. (In Russ.) https://doi.org/10.37174/2587-7593-2023-6-2-85-94