Photodynamic Therapy Healing a Refractory Radiation-Induced Ulcer on the Chest Wall Postmastectomy Radiotherapy for Breast Cancer: A Case Report and Literature Overview

TL;DR

A 75-year-old woman with a long-lasting chest wound after breast cancer treatment healed with photodynamic therapy, a treatment not commonly used for such wounds.

Contribution

This is the first detailed report of photodynamic therapy successfully healing a chronic radiation-induced ulcer after breast cancer treatment.

Findings

The patient's wound showed improvement after three photodynamic therapy sessions and continued healing for 14 months.

Photodynamic therapy is presented as a viable alternative to hyperbaric oxygen therapy for chronic wound healing in cancer patients.

The case highlights the potential of PDT in treating refractory ulcers following mastectomy and radiotherapy.

Abstract

Photodynamic therapy (PDT) has been used to treat cancers. It has also been used to treat infectious diseases and inflammatory conditions. PDT promotes wound healing, while clinical use of PDT for wound healing is uncommon and not thoroughly investigated. We report a 75-year-old female with a radiation-induced non-healing ulcer for five years on the chest wall postmastectomy radiotherapy. Biopsy showed epidermal erosion with dermal inflammation but no recurrent cancer. She was referred from the wound care clinic after multiple unsuccessful attempts to manage wound healing for two years involving daily home nursing visits. PDT was discussed with the patient who consented to PDT instead of hyperbaric oxygen therapy (HBOT) for fear of its side effects. Her wound improved after a total of three treatments and the process of wound healing continued for 14 months since her first treatment session. The presented case supports the beneficial effects of PDT on chronic ulceration impeding healing of a postmastectomy radiotherapy wound. To our knowledge, this report is unique in documenting details of PDT healing a chronic refractory ulcer of five years, which developed after cancer therapy (mastectomy and radiotherapy). Further clinical study of PDT is needed on wound healing post-surgery and radiation in cancer patients. An overview of HBOT in comparison with PDT for wound healing is presented.

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