Volumetric-modulated arc therapy improved heart and lung sparing for a left-sided chest wall and regional nodal irradiation case (original) (raw)

28 n APPLIED RADIATION ONCOLOGY www.appliedradiationoncology.com September 2017 CASE SUMMARY A 56-year-old postmenopausal woman initially presented in October 2013 with complaints of intermittent left breast pain, redness and a left axillary mass for several months. Clinical examination was notable for an edematous and erythematous left breast with peau d’orange and a palpable underlying 6-cm mass with bulky axillary lymphadenopathy. Core biopsies of the left breast and left axilla demonstrated poorly differentiated ductal carcinoma, ER-/PR-/Her2-. Skin biopsy was negative. Workup was negative for metastatic disease, and the cancer was staged IIIB cT4d N2a M0. Beginning in December 2013, the patient was treated with neoadjuvant chemotherapy consisting of 4 cycles of dose dense Adriamycin and cyclophosphamide (AC) followed by Taxol and carboplatin (TC), which consisted of 12 cycles of Taxol and 3 cycles of carboplatin (the last dose of carboplatin was held due to electrolyte wasting)...