Academic Radiotherapy, University of Thessaly, Medical School, Greece ; Radiation Oncology Department, University Hospital of Larissa, Greece.
Academic Medical Physics, University of Thessaly, Medical School, Greece ; Medical Physics Department, University Hospital of Larissa.
Breast Cancer (Dove Med Press). 2012 Jan 24;4:3-8. doi: 10.2147/BCTT.S28412. eCollection 2012.
Connective vascular diseases (CVD), including scleroderma, are reported to represent for some researchers a relative contraindication and for others absolute contraindication for radiotherapy. The purpose of our study is to add four new cases to the existing body of international literature and to determine whether women with pre-existing scleroderma who have been surgically treated for early breast cancer could undergo postsurgical radiotherapy without serious early and late complications.
From May 1998 to November 2010, we irradiated for early breast cancer four patients suffering from pre-existing scleroderma; after conservative surgery, we performed whole breast postoperative radiotherapy of 50.4 Gy total dose to the whole breast plus a 9 Gy boost to the tumor bed. We reviewed the records of all four patients and evaluated the early and late reactions using acute radiation morbidity scoring criteria (Radiation Therapy Oncology Group [RTOG], American College of Radiology, Philadelphia, PA) and late radiation morbidity scoring scheme (European Organisation for Research and Treatment of Cancer [EORTC], Brussels, Belgium and RTOG).
After a median follow-up of 105 months (range 12-155 months) the early and late toxicity concerning the skin, the subcutaneous tissues, the lungs, and the heart have been acceptable and are in full accordance with what have been reported in international literature.
This study matches global experience, which shows that patients with scleroderma and breast cancer must be discussed by the multidisciplinary tumor board in order for a personalized treatment strategy to be formulated. Radiation therapy can be proposed as a postsurgical therapeutic option in selected cases.
结缔组织血管疾病（CVD），包括硬皮病，据报道对一些研究人员来说是相对禁忌证，对另一些研究人员来说则是绝对禁忌证。我们研究的目的是在现有的国际文献基础上增加 4 例新病例，并确定患有早期乳腺癌且已接受手术治疗的预先存在的硬皮病女性患者是否可以在没有严重早期和晚期并发症的情况下接受术后放疗。
1998 年 5 月至 2010 年 11 月，我们对 4 例患有预先存在的硬皮病的早期乳腺癌患者进行了放射治疗；在进行保乳手术后，我们对整个乳房进行了 50.4 Gy 的全剂量术后放疗，并对肿瘤床进行了 9 Gy 的加量照射。我们回顾了所有 4 例患者的记录，并使用急性放射毒性评分标准（放射治疗肿瘤学组 [RTOG]，美国放射肿瘤学会，费城，宾夕法尼亚州）和晚期放射毒性评分方案（欧洲癌症研究与治疗组织 [EORTC]，布鲁塞尔，比利时和 RTOG）评估了早期和晚期反应。
在中位随访 105 个月（范围 12-155 个月）后，皮肤、皮下组织、肺和心脏的早期和晚期毒性是可以接受的，与国际文献中的报道完全一致。
本研究与全球经验相符，表明患有硬皮病和乳腺癌的患者必须由多学科肿瘤委员会进行讨论，以便制定个性化的治疗策略。在选定的病例中，可以提出放射治疗作为术后治疗选择。
