Case Report
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World J Radiol. Apr 28, 2010; 2(4): 148-150
Published online Apr 28, 2010. doi: 10.4329/wjr.v2.i4.148
Could helical tomotherapy do whole brain radiotherapy and radiosurgery?
Youlia M Kirova, Cyrus Chargari, Sofia Zefkili, François Campana
Youlia M Kirova, Cyrus Chargari, Sofia Zefkili, François Campana, Department of Radiation Oncology, Institut Curie, 75005 Paris, France
Author contributions: Kirova YM and Chargari C wrote and edited the paper, performed the dosimetry and treated the patient; Zefkili S performed the dosimetry and edited the paper; Campana F treated the patient and edited the paper.
Correspondence to: Youlia M Kirova, MD, Department of Radiation Oncology, Institut Curie, 26, rue d’Ulm, 75005 Paris, France.
Telephone: +33-1-44324637 Fax: +33-1-53102653
Received: February 6, 2010
Revised: March 23, 2010
Accepted: April 1, 2010
Published online: April 28, 2010

Whole brain radiotherapy (WBRT) remains the standard management of breast cancer patients with brain metastases, allowing for symptomatic improvement and good local control in most patients. However, its results remain suboptimal in terms of both efficacy and toxicity. In highly selected breast cancer patients, stereotaxic radiotherapy demonstrates a very good local control with a low toxicity. With the purpose of improving the efficacy/toxicity ratio, we report the association of integrated boost with WBRT in a breast cancer patient with brain metastases. Two and a half years after completion of helical tomotherapy (HT), the patient experienced clinical and radiological complete remission of her brain disease. No delayed toxicity occurred and the patient kept her hair without need of radiosurgical procedure. The HT provided a high dosimetric homogeneity, delivering integrated radiation boosts, and avoiding critical structures involved in long-term neurological toxicity. Further assessment is required and recruitment of breast cancer patients into clinical trials is encouraged.

Keywords: Brain metastases, Radiotherapy, Breast cancer, Tomotherapy