The Promising Effects of Lattice Radiotherapy for Large, Fungating, or Ulcerating Breast Cancers: A Prospective Single-center Study
Gianluca Ferini, Valentina Zagardo, Anna Viola, Domenico Patanè, Silvana Parisi, Francesco Cuccia, Antonio Piras, Paolo Fontana, Giovanni Maugeri, Angela Prestifilippo, Andrea Boncoraglio, Antonio Pontoriero, Mandara Harikar, Stefano Pergolizzi
Abstract
BACKGROUND/AIM: To evaluate the safety and efficacy of lattice radiotherapy (LRT) for large, inoperable breast cancers. PATIENTS AND METHODS: In this prospective study, patients who underwent LRT for breast tumors that were ulcerating/fungating/extensively eroding the chest wall, and were ineligible/unwilling for surgery, were enrolled from May 2021 to Nov 2023. Baseline Eastern Cooperative Oncology Group (ECOG) status, pre- and post-LRT numerical rating scale (NRS), and post-LRT changes in quality of life (QoL) were recorded. Survival outcomes were reported at 6 months and 1-year. Median rates of survival and dosimetric parameters were calculated. Kaplan-Meier curves for overall survival (OS), cancer-specific survival (CSS), and failure of local control (LC) were constructed. RESULTS: Ten patients (8 females) underwent LRT. The median age was 76 years (range=57-99 years) and the median ECOG performance status was 2.5 (range=1-4). The planned schedule was completed by 9/10 patients, accounting for a 90% compliance rate. Among patients with pain (n=7), NRS rapidly reduced from 7 (range=5-10) to 3 (range=1-6). The median equivalent uniform dose was 0.71 Gy (0.09-1.59 Gy). The actuarial rates of 6-month LC, CSS, and OS were 75%, 89%, and 61%, respectively, with only LC rate changing to 50% at 1 year. Two patients had local relapse at the six-month and 1-year follow-up, respectively, after having achieved a complete response at three months, and two others died of COVID-19 infection and ischemic stroke. CONCLUSION: LRT was found to be effective and safe in palliating symptoms among patients with large inoperable breast tumors.