Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: A case report of two different radiation schedules

Maria Paola Ciliberti, Roberta Carbonara, Antonietta Grillo, Anna Maria Leo, Ivan Lolli, Carmela Ostuni, Laura Troiani, Barbara Turi, Simona Vallarelli, Angela Sardaro

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Skin metastases from pancreatic neuroendocrine carcinoma (PNEC) are rare and their palliative treatment is challenging. We report our experience in the multimodal management of one of the few reported cases of metastatic PNEC with multiple visceral and subcutaneous secondary lesions, focusing on the effectiveness of palliative radiotherapy for skin metastases. Case presentation: A 61-years old woman affected by a metastatic PNEC-with subcutaneous growing and bleeding secondary lesions (at the scalp, right scapular region and at the back of the left thoracic wall, respectively)-obtained a successful control of visceral metastases with the use of chemotherapy and an unexpected local response of her skin metastases with palliative radiotherapy. In particular, two subsequent radiation treatments were performed using different fractionation schedules (30 Gy in 10 fractions and 20 Gy in 5 fractions, respectively). Both radiation treatments were well-tolerated and patient's quality of life was improved. Local response was maintained until patient's death-that occurred due to cachexia. Conclusions: The presented case highlights the effectiveness and the good tolerance of radiotherapy in the treatment of subcutaneous metastases; nevertheless, further knowledge of the optimal local palliative approach for PNEC metastatic sites is necessary. The experience gained in this work is the occasion to encourage a routine integrated multidisciplinary team management of metastatic PNECs because of their clinical complexity. The aim is to guarantee the optimization of the care with personalized and more effective systemic and local treatments-also including supportive cares and treatment-related side effects management.

Original languageEnglish
Article number311
JournalBMC Cancer
Volume20
Issue number1
DOIs
Publication statusPublished - Apr 15 2020

Keywords

  • Palliative radiotherapy
  • Pancreatic neuroendocrine carcinoma
  • Subcutaneous metastases

ASJC Scopus subject areas

  • Genetics
  • Oncology
  • Cancer Research

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