Radical chest wall resection and hyperfractionated accelerated radiotherapy for radiation‐associated angiosarcoma of the breast: A safe and effective treatment strategy.
Abstract: Radiation‐associated angiosarcomas (RAS) of the breast are vascular tumors arising in a previous radiation field for primary breast cancer. They occur rarely but confer a high probability of local recurrence (LR) and poor prognosis. A wide range of treatment strategies exists due to limite...
| Publicado en: | Breast Journal Vol. 24; no. 3; pp. 245 - 253 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May/Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129978268&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129978268 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1075122X ET6 jtl: Breast Journal issn: 1075122X maglogo: Y pubinfo: dt: May/Jun2018 vid: 24 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129978268 129978268 129978268 10.1111/tbj.12886 129978268 ppf: 245 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Radical chest wall resection and hyperfractionated accelerated radiotherapy for radiation‐associated angiosarcoma of the breast: A safe and effective treatment strategy. aug: au: Donovan, Elysia K. Corbett, Thomas Vansantvoort, Jasmin Kak, Ipshita Popvic, Snezana Heller, Barbara affil: Department of Radiation Oncology, McMaster University, Hamilton, ON, Canada sug: subj: Thoracic Surgery Sarcoma Radiotherapy Treatment Outcomes Breast Neoplasms Radiotherapy Radiotherapy, Adjuvant Human Neoplasm Recurrence, Local Prevention and Control Cancer Care Facilities Mastectomy Methods Radiation Dosage Radiotherapy, Conformal Breast Neoplasms Prognosis Neoplasm Metastasis Severity of Illness Wound Healing Osteitis Radiotherapy ab: Abstract: Radiation‐associated angiosarcomas (RAS) of the breast are vascular tumors arising in a previous radiation field for primary breast cancer. They occur rarely but confer a high probability of local recurrence (LR) and poor prognosis. A wide range of treatment strategies exists due to limited evidence, and although resection is the definitive treatment, LR rates remain high. It has been suggested hyperfractionated accelerated radiotherapy (HART) has the potential to prevent LR. The sarcoma group at the Juravinski Cancer Centre (JCC) reports our experience of nine patients treated with radical resection and adjuvant HART. This is one of the largest reported cohorts we are aware of to receive this treatment. The JCC pathologic data base was reviewed between the year 2006‐2015 for patients with RAS. Patients who received radical surgery and immediate HART were eligible. Patients underwent radical chest wall resection and en bloc mastectomy. Radiotherapy was then delivered to 4500 cGy in 45 fractions three times daily using parallel opposed photon beams and electron patching, or volumetric modulated arc therapy. Primary outcome was recurrence‐free survival in months, and records were reviewed for descriptive reports of toxicity. We compared our results to other institutions experience with surgery alone or other adjuvant therapies. Median follow‐up was 19 months (range 3‐41 months). One of nine patients developed LR and developed metastasis, one died of other causes, and seven are alive with no recurrent disease. There were seven reports of mild skin toxicity during treatment. One patient developed chronic wound healing complications which eventually resolved and one patient developed asymptomatic radiation osteitis of a rib. On the basis of our experience at the JCC, we recommend treatment with radical chest wall resection and adjuvant HART to prevent recurrence in RAS patients. As demonstrated in our patients, the large normal tissue volume irradiated is tolerable with in combination with small fraction sizes, and no major toxicities were seen. Further investigation into adjuvant therapy regimens and prospective studies are required to reach consensus on optimal treatment for this disease. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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