ABSTRACT
The patient was a 47-year-old female with stage IV breast cancer and multiple bone metastases. She received various systemic therapies (hormone therapy and chemotherapy) and underwent mastectomy between 2013 and 2018; in the beginning of 2018, she started experiencing bone metastatic pain in the right hip joint and neural pain on the dorsal side of the left thigh. These symptoms worsened gradually, and nonsteroidal anti-inflammatory analgesics or narcotic analgesics were not effective for treating this pain. Strontium-89 (89Sr) treatment was administered in April 2018. The pain was relieved immediately after 89Sr treatment. The patient's quality of life improved markedly. She spent her remaining life without using analgesic drugs, until she died in October 2018 due to exacerbation of the original disease. Although radiotherapy is believed to be less effective for neuropathic pain than for bone metastatic pain, it should be considered as a treatment option in patients with neuropathic pain.
Subject(s)
Bone Neoplasms/complications , Bone Neoplasms/secondary , Breast Neoplasms/pathology , Neuralgia/etiology , Neuralgia/radiotherapy , Pain Management/methods , Strontium Radioisotopes/therapeutic use , Breast Neoplasms/therapy , Fatal Outcome , Female , Humans , Middle Aged , Quality of Life , Treatment OutcomeABSTRACT
Several cases of hormone receptor-positive HER2-negative advanced and recurrent breast cancer treated with fulvestrant (FUL)were retrospectively investigated to assess the efficacy and safety of the treatment. FUL was administered to a total of 41 patients-33 with recurrent and 8 with Stage IV cancer-from January 2012 to September 2016. The median number of lines that used FUL was 3, the median time to treatment failure(TTF)was 7 months, the overall response rate(RR)was 19.5%, and the clinical benefit rate(CBR)was 53.6%. Our result was similar to those of the FIRST and the FALCON studies, which showed a decrease in RR after the fourth-line. With regard to RR, FUL seemed to provide better results at Cthird-lines of treatment. While a shorter TTF was seen in the cases with liver metastases, a longer TTF was seen in the cases with soft tissue metastases. Therefore, it may be helpful to consider the site of metastasis when predicting the effects of FUL.