Background and purpose Synchronous bilateral breast cancer (SBBC) accounts for 13.5% of breast cancer patients. The aim of this study was to evaluate dosimetric issues, clinical outcomes, and acute toxicities for SBBC patients receiving synchronous bilateral hypofractionated radiotherapy (SBHRT) and to compare them with patients treated with synchronous bilateral normofractionated RT schedule (SBNRT). Materials and methods From April 2016 to March 2020, 39 SBBC patients were referred to our institution. Patients were divided according to their prescription dose: Group A: 50 Gy/25fx (fractions), B: 6064 Gy/25fx, C: 40.05 Gy/15fx; D: 48 Gy/15fx. Toxicity was evaluated using Common Terminology Criteria for Adverse Events (CTCAE)v.5.0. Results 34 patients were finally evaluated. Median follow-up was 24 months for NF schedule and 9 months for HF schedule. In the HF schedule, no acute side-effects > G2 were observed and no dermatitis was reported in 6th month´s assessments. 95% of patients have no evidence of disease and only 1 patient presented local relapse in the first mammography after RT. No distant failures or deaths were observed. Regarding dosimetric issues, the inter-patient average Dmean for the heart was: Group A: 5.0 Gy (4.65.5), Group B: 4.4 Gy (4.15.4), Group C: 4.8 Gy (4.55.1) and Group D: 5.3 Gy (4.45.6). For the lungs, the inter-patient average Dmean was: Group A: 10.8 Gy (9.812.2), Group B: 11.5 Gy (11.312), Group C: 9.8 Gy (9.310.5) and Group D: 10.5 Gy (1011.3). Conclusions This is the first study reporting the safety, feasibility, and tolerability of 40.05 Gy/15fx over 3 weeks for the treatment of SBBC patients. Further study with larger accrual is mandatory (AU)
Humans , Female , Breast Neoplasms/radiotherapy , Neoplasms, Multiple Primary/radiotherapy , Radiation Dose Hypofractionation , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Follow-Up Studies , Heart/radiation effects , Lung/radiation effects , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/surgery , Organs at Risk/radiation effects , Prospective Studies , Radiotherapy, Intensity-Modulated/adverse effects
BACKGROUND AND PURPOSE: Synchronous bilateral breast cancer (SBBC) accounts for 1-3.5% of breast cancer patients. The aim of this study was to evaluate dosimetric issues, clinical outcomes, and acute toxicities for SBBC patients receiving synchronous bilateral hypofractionated radiotherapy (SBHRT) and to compare them with patients treated with synchronous bilateral normofractionated RT schedule (SBNRT). MATERIALS AND METHODS: From April 2016 to March 2020, 39 SBBC patients were referred to our institution. Patients were divided according to their prescription dose: Group A: 50 Gy/25fx (fractions), B: 60-64 Gy/25fx, C: 40.05 Gy/15fx; D: 48 Gy/15fx. Toxicity was evaluated using Common Terminology Criteria for Adverse Events (CTCAE)v.5.0. RESULTS: 34 patients were finally evaluated. Median follow-up was 24 months for NF schedule and 9 months for HF schedule. In the HF schedule, no acute side-effects > G2 were observed and no dermatitis was reported in 6th month´s assessments. 95% of patients have no evidence of disease and only 1 patient presented local relapse in the first mammography after RT. No distant failures or deaths were observed. Regarding dosimetric issues, the inter-patient average Dmean for the heart was: Group A: 5.0 Gy (4.6-5.5), Group B: 4.4 Gy (4.1-5.4), Group C: 4.8 Gy (4.5-5.1) and Group D: 5.3 Gy (4.4-5.6). For the lungs, the inter-patient average Dmean was: Group A: 10.8 Gy (9.8-12.2), Group B: 11.5 Gy (11.3-12), Group C: 9.8 Gy (9.3-10.5) and Group D: 10.5 Gy (10-11.3). CONCLUSIONS: This is the first study reporting the safety, feasibility, and tolerability of 40.05 Gy/15fx over 3 weeks for the treatment of SBBC patients. Further study with larger accrual is mandatory.
Breast Neoplasms/radiotherapy , Neoplasms, Multiple Primary/radiotherapy , Radiation Dose Hypofractionation , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Feasibility Studies , Female , Follow-Up Studies , Heart/radiation effects , Humans , Lung/radiation effects , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/surgery , Organs at Risk/radiation effects , Prospective Studies , Radiotherapy, Intensity-Modulated/adverse effects , Time Factors
Brain Neoplasms/radiotherapy , Pregnancy Complications, Neoplastic/radiotherapy , Trophoblastic Neoplasms/radiotherapy , Uterine Neoplasms/radiotherapy , Brain Neoplasms/secondary , Dose-Response Relationship, Radiation , Female , Humans , Pregnancy , Pregnancy Complications, Neoplastic/pathology , Radiotherapy Dosage , Trophoblastic Neoplasms/pathology , Uterine Neoplasms/pathology
Adenocarcinoma/therapy , Breast Neoplasms/therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Drug Administration Schedule , Female , Humans , Mastectomy , Middle Aged , Prospective Studies , Radiotherapy Dosage , Survival Analysis , Treatment Outcome
Between 25% and 35% of all patients with cancer, will develop metastases to the brain. Gastrointestinal neoplasms are responsible for 8% of all cases of metastatic brain involvement. The frequency of brain metastases in carcinoma of the colon ranges from 0.3 to 6%, and this location is usually accompanied by metastatic involvement of the lung and liver. Cerebral metastatic lesions are uncommon in colon cancer, and are usually a late manifestation of the disease. Because of the rarity of this complication, we report a case of metastatic colon adenocarcinoma to the brain, and we review the literature on this subject.
Adenocarcinoma/secondary , Brain Neoplasms/secondary , Colonic Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Brain/diagnostic imaging , Brain Neoplasms/diagnosis , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/secondary , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Tomography, X-Ray Computed