POSTOPERATIVE THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY IN THE PATIENT WITH A SIGNIFICANT CARDIOVASCULAR RISK: A CASE REPORT

Milica S Radić; Aleksandar  Popovic; Katarina Krasic; Andrija Jovic; Irena Conic; Ana Cvetanovic; Ivan Petkovic

Milica S Radić Klinika za onkologiju, Klinicki centar Niš Medicinski faultet, Univerzitet u Nišu, student doktorskih studija
Aleksandar Popovic Clinic of Oncology, University Clinical Center Nis, Nis, Serbia
Katarina Krasic Clinic of Oncology, Clinical Center Kragujevac, Kragujevac, Serbia
Andrija Jovic Clinic of Dermatovenereology, University Clinical Center Nis, Nis, Serbia
Irena Conic Clinic of Oncology, University Clinical Center Nis, Nis, Serbia Department of Oncology, Faculty of Medicine, University of Nis, Nis, Serbia
Ana Cvetanovic Clinic of Oncology, University Clinical Center Nis, Nis, Serbia Department of Oncology, Faculty of Medicine, University of Nis, Nis, Serbia
Ivan Petkovic Clinic of Oncology, University Clinical Center Nis, Nis, Serbia Department of Oncology, Faculty of Medicine, University of Nis, Nis, Serbia

Keywords: breast cancer, cardiotoxicity, radiotherapy

Abstract

Radiotherapy of breast cancer represents an essential component in the overall multidisciplinary breast cancer treatment. Considering the satisfactory results of the application of the multimodal treatment as well as its role in the decrease in the mortality rate of breast cancer patients, the focus has shifted towards monitoring acute as well as chronic complications occurring as a consequence of oncological treatment, intending to preserve the patient’s quality of life. Complications are numerous and vary from the local ones (dermatitis) to more serious forms including dysfunctions of the cardiovascular system. The application of 3D radiotherapy on the patient in this case report as the most used method in our centre points to its low acute toxic effect, while the observed negative effects in the high-risk patient were removed, which resulted in satisfactory therapeutic effects despite the limited technical equipment of the centre.

References

Akram M, Iqbal M, Daniyal M, Khan AU. Awareness and current knowledge of breast cancer. Biol Res 2017;50(1):33. [PubMed][CrossRef]

Andersen ER, Eilertsen G, Myklebust AM, Eriksen S. Women's experience of acute skin toxicity following radiation therapy in breast cancer. J Multidiscip Healthc 2018;11:139-48. [PubMed][CrossRef]

Bergom C, Bradley JA, Ng AK, Samson P, Robinson C, Lopez-Mattei J, et al. Past, Present, and Future of Radiation-Induced Cardiotoxicity: Refinements in Targeting, Surveillance, and Risk Stratification. JACC Cardio Oncol 2021;3:343–59. [PubMed][CrossRef]

Bird BR, Swain SM. Cardiac toxicity in breast cancer survivors: review of potential cardiac problems. Clin Cancer Res 2008;14(1):14–24. [PubMed][CrossRef]

Di Franco R, Calvanese M, Murino P, Manzo R, Guida C, Di Gennaro D, et al. Skin toxicity from external beam radiation therapy in breast cancer patients: protective effects of Resveratrol, Lycopene, Vitamin C and anthocianin (Ixor®). Radiat Oncol 2012;7:12. [PubMed][CrossRef]

Díaz-Gavela AA, Figueiras-Graillet L, Luis ÁM, Salas Segura J, Ciérvide R, Del Cerro Peñalver E, et al. Breast radiotherapy-related cardiotoxicity. when, how, why. Risk prevention and control strategies. Cancers (Basel) 2021;13(7):1712. [PubMed][CrossRef]

Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, Van de Vijver MJ, editors. WHO Classification of Tumours of the Breast. 4th ed. Lyon: IARC; 2012.

McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, et al. EBCTCG (Early Breast Cancer Trialists’ Collaborative Group). Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 2014;383(9935):2127-35. [PubMed][CrossRef]

Morrow M, Burstein HJ, Harris JR. Malignant tumors of the breast. In: DeVita VT Jr., Lawrence TS, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. 10th ed. Vol 79. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015. p. 1117–56.

Rietman JS, Dijkstra PU, Hoekstra HJ, Eisma WH, Szabo BG, Groothoff JW, et al. Late morbidity after treatment of breast cancer in relation to daily activities and quality of life: a systematic review. Eur J Surg Oncol 2003;29:229-38. [PubMed][CrossRef]

Shah C, Badiyan S, Berry S, Khan AJ, Goyal S, Schulte K, et al. Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy. Radiother Oncol 2014;112(1):9–16. [PubMed][CrossRef]

Shah R, Rosso K, Nathanson SD. Pathogenesis, prevention, diagnosis and treatment of breast cancer. World J Clin Oncol 2014;5:283–8. [PubMed][CrossRef]

Soumarová R, Rušinová L. Cardiotoxicity of breast cancer radiotherapy - overview of current results. Rep Pract Oncol Radiother 2020;25(2):182-6. [PubMed][CrossRef]

Stowe HB, Andruska ND, Reynoso F, Thomas M, Bergom C. Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold. Breast Cancer (Dove Med Press) 2022;14:175-86. [PubMed][CrossRef]

Zhu Z, Li L, Ye Z, Fu T, Du Y, Shi A, et al. Prognostic value of routine laboratory variables in prediction of breast cancer recurrence. Sci Rep 2017;7:8135. [PubMed][CrossRef]