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Giant Fungated Locally Advanced Breast Carcinoma Responded to Hypofractionated Radiotherapy Combined with Apatinib: A Case Report and Literature Review
Authors Liu H, Liu B, Ma Y, Guo L, Wu D, Shi A, Liu M
Received 8 November 2020
Accepted for publication 7 January 2021
Published 22 January 2021 Volume 2021:13 Pages 605—611
DOI https://doi.org/10.2147/CMAR.S291029
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Hui Liu,1,* Bailong Liu,1,* Yunfei Ma,1 Liang Guo,2 Di Wu,3 Aiping Shi,3 Min Liu1
1Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, People’s Republic of China; 2Department of Pathology, The First Hospital of Jilin University, Changchun 130021, People’s Republic of China; 3Department of Breast Surgery, The First Hospital of Jilin University, Changchun 130021, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Aiping Shi
Department of Breast Surgery, The First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, People’s Republic of China
Tel + 86 133-6430-8696
Email sap@jlu.edu.cn
Min Liu
Department of Radiation Oncology, The First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, People’s Republic of China
Tel + 86 158-0430-2751
Email lmin99@jlu.edu.cn
Abstract: Locally advanced breast cancer (LABC) is frequently encountered in clinical practice. Primary systemic therapy is regarded as the cornerstone of LABC management to downstage the disease and enable surgery. However, multiple lines of systemic agents may fail to control tumor growth in a considerable number of patients, and few options remain available for such patients. Here, we present a case of triple-negative, right breast cancer that progressed aggressively despite 3 lines of standard chemotherapy. The patient suffered from severe skin ulceration, bleeding, pain, infection, and fungation. The small-molecular tyrosine kinase inhibitor (TKI) apatinib was initiated, which targets vascular endothelial growth factor receptor 2 (VEGFR2). The patient then underwent hypofractionated irradiation applied to the whole right breast at 40 Gy/8 f. The tumor responded dramatically to this combination, and a near-complete remission (CR) response was achieved 2 months after irradiation. Our case is novel and instructional and demonstrated the efficacy and safety of hypofractionated irradiation combined with antiangiogenesis for the treatment of intractable LABC, shedding light on this difficult situation. In the near future, large-scale clinical trials will be initiated to further explore this issue.
Keywords: intractable locally advanced breast cancer, triple negative breast cancer, hypofraction, irradiation, antiangiogenesis
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