Would you give palliative breast RT to a patient receiving weekly paclitaxel for rapidly progressing metastatic disease?

Given symptomatic disease and need for palliation, I would treat. I would offer 30 Gy/10 fractions. If localized lesion, I would target this with mini-tangents, limiting dose to lung, given concurrent paclitaxel. If involving skin, I would bolus daily.

We would also feel comfortable using palliative RT since it can provide meaningful palliation. While the dose of taxol described is slightly higher than what we use during concurrent chemo/RT for lung cancer, the irradiated lung volumes will be far smaller in this setting, so we suspect this would b...

In addition to the 30 Gy in 10 fractions, I would start with a GRID boost of 15 Gy x 1 using the MLC-based approach described in the literature for bulky breast cancer as published in 2012 by Neuner et al., PMID 21531514.