Successful palliative hypofractionated radiotherapy with superficial hyperthermia for heavily pretreated cutaneous breast cancer lesions.

BACKGROUND: Hypofractionated radiotherapy has been successfully shown to reduce pain and skin lesion bleeding. In previously irradiated areas, the effect of hypofractionated radiotherapy (weekly 4 Gy radiotherapy to a total dose of 20 Gy) can be enhanced by hyperthermia: increasing temperatures in target areas up to 43 °C. Superficial hyperthermia in combination with radiotherapy is a proven and widely applied treatment for recurrent breast cancer and malignant melanoma. Literature on the use of radiotherapy to cause hemostasis of the skin is available; however, the role of hyperthermia in combination with radiotherapy for this indication is not yet described.

SHORT COMMUNICATION: We present a 72-year old woman with a history of breast cancer with painful and bleeding cutaneous metastases in the right upper arm and right breast which had a large impact on her quality of life. The metastases progressed under T‑deruxtecan treatment, and she was referred for re-irradiation to control the bleeding skin. Hyperthermia was added as a tumor-selective radiosensitizer to the radiotherapy fractions to enhance irradiation. The main treatment goal was to reduce bleeding and itching of the cutaneous lesions. The patient was treated once a week with hyperthermia immediately followed by 4 Gy radiotherapy fractions for 5 consecutive weeks. Bleeding was already decreased during the treatment series and the skin healed within 4 weeks after therapy.

CONCLUSION: Treatment with 5 × 4 Gy radiotherapy combined with hyperthermia sessions was a successful palliative therapy for bleeding cutaneous metastases. The treatment schedule was well-tolerated and the skin fully recovered within 1 month.