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Scleroderma and radiotherapy as part of the treatment of breast carcinoma: Six cases and a short critical review of the literature

Published online by Cambridge University Press:  01 March 2007

Youlia M. Kirova ,
Marc A. Bollet ,
Isabelle Dys ,
Francois Campana ,
Fatima Laki ,
Remi Dendale ,
Remy Salmon  and
Alain Fourquet
Youlia M. Kirova
Affiliation:
Department of Radiation Oncology, Institut Curie, Paris, France
Marc A. Bollet
Affiliation:
Department of Radiation Oncology, Institut Curie, Paris, France
Isabelle Dys
Affiliation:
Department of Surgery, Institut Curie, Paris, France
Francois Campana
Affiliation:
Department of Radiation Oncology, Institut Curie, Paris, France
Fatima Laki
Affiliation:
Department of Surgery, Institut Curie, Paris, France
Remi Dendale
Affiliation:
Department of Radiation Oncology, Institut Curie, Paris, France
Remy Salmon
Affiliation:
Department of Surgery, Institut Curie, Paris, France
Alain Fourquet
Affiliation:
Department of Radiation Oncology, Institut Curie, Paris, France
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Abstract

Purpose: To add six new cases to the literature and to determine whether women with pre-existing scleroderma have an increased incidence of complications after breast-conserving therapy.

Methods and Materials: From 1995 to 2005, nine patients with pre-existing scleroderma were treated for their breast cancer at the Institute Curie. Six of them underwent radiotherapy. The patients who underwent radiotherapy were irradiated using high-energy photons of a cobalt unit and/or linear accelerator, either before or after surgery, or were exclusively treated using radiation therapy. The early and late skin reactions have been evaluated using the Acute Radiation Morbidity Scoring Criteria (RTOG) and Late Radiation Morbidity Scoring Scheme (RTOG, EORTC).

Results: Median follow-up of the six irradiated patients was 34 months (range from 10 to 120 months). Early reactions were as follows: grade 1 in two cases, grade 2 in two cases, and grade 3 in two cases. Late toxicity was as follows: grade 0 in three patients, currently at 56, 48, and 12 months of follow-up; grade 1, slight atrophy, in two patients; grade 3 reaction with marked atrophy in one patient, followed up for 120 months now. There was no toxicity worse than grade 3 in these series.

Conclusions: This small study cannot provide evidence that scleroderma increases the risk of developing early and late toxicity. Patients with scleroderma must be discussed in multidisciplinary meetings to adapt their treatment to their rheumatologic history. When radiotherapy is considered, more attention must be paid to the protection of normal tissues. Careful follow-up during and after the radiation therapy remains of paramount importance in this specific population of patients.

Keywords

Breast cancersclerodermaradiation therapysurgerytoxicityearly and late side effects
Type
Short Communication
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 1 , March 2007 , pp. 47 - 51
Copyright
Copyright © Cambridge University Press 2007

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