Helical tomotherapy for inoperable breast cancer: a new promising tool.
BACKGROUND
We investigated the feasibility of helical tomotherapy (HT) for inoperable large breast tumors, after failing to achieve adequate treatment planning with conformal radiation techniques.


METHODS
Five consecutive patients with locally advanced breast cancer (LABC) were treated by preoperative HT. All patients received up-front chemotherapy before HT. Irradiated volumes included breast and nodal areas (45-50 Gy) in 4 patients. One patient received a simultaneous integrated boost (55 Gy) to gross tumor volume (GTV) without lymph node irradiation. Acute toxicity was assessed with Common Toxicity Criteria for Adverse Events v.4. Patients were evaluated for surgery at the end of treatment.


RESULTS
Patients were staged IIB to IIIC (according to the AJCC staging system 2010). HT was associated in 4 patients with concomitant chemotherapy (5-fluorouracil and vinorelbine). Two patients were scored with grade 3 skin toxicity (had not completed HT) and one with grade 3 febrile neutropenia. One patient stopped HT with grade 2 skin toxicity. All patients were able to undergo mastectomy at a median interval of 43 days (31-52) from HT. Pathological partial response was seen in all patients.


CONCLUSIONS
HT is feasible with acceptable toxicity profiles, potentially increased by chemotherapy. These preliminary results prompt us to consider a phase II study.
Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
Ciprian
C
Chira
Youlia M
YM
Kirova
Xavier
X
Liem
François
F
Campana
Dominique
D
Peurien
Malika
M
Amessis
Nathalie
N
Fournier-Bidoz
Jean-Yves
JY
Pierga
Rémi
R
Dendale
Pierre
P
Bey
Alain
A
Fourquet
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome