論文

Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

IntroductionProstate carcinoma is typically diagnosed and treated, and it rarely manifests as cutaneous metastases. We herein report electron radiotherapy for the treatment of cutaneous metastases causing cellulitis, with a durable clinical response achieved.Case presentationA 70‐year‐old male patient with scrotal cutaneous metastasis of prostate carcinoma was undergoing treatment with docetaxel chemotherapy due to recurring cellulitis originating from the scrotum, and his treatment was interrupted. We administered electron radiotherapy to the scrotal cutaneous metastasis lesions, as irradiation was difficult, and obtained a good clinical effect. Subsequently, he continued chemotherapy, and the scrotal lesions remained clear and dry with no recurring cellulitis for 1 year.ConclusionElectron radiotherapy is one of the safe and effective treatment options for controlling cutaneous metastasis of prostate carcinoma.