Abstract
The aim of this retrospective analysis was to evaluate the safety and efficacy of local hyperthermia (HT) and reirradiation (ReRT) in the management of preirradiated locoregional recurrent breast cancers at Kantonsspital Aarau, Switzerland. Twenty-four previously irradiated patients who had developed locoregional recurrences in the chest wall or breast, with or without regional lymph node involvement, were reirradiated to a mean dose of 36.8 Gy (range 20-50 Gy) delivered at a mean dose per fraction of 2.33 Gy (range 1.8-4.0 Gy). All patients received local HT at 41 to 43 °C, once or twice a week prior to radiotherapy. Online thermometry was carried out during the hyperthermia sessions. An overall objective response rate of 91.7% (22/24) with a complete response in 66.7% (16/24) of patients and partial response in 25% (6/24) of patients was observed. Post-thermoradiotherapy follow-up ranged from 1 to 38 months (median 10 months). The 3-year actuarial local control rate was 59.7%. More patients who attained complete response had sustained locoregional control until their death or last follow-up when compared with those who were partial or non-responders (median local disease-free survival for complete responders not reached; for partial and non-responders 4 months; p <0.001). Post-retreatment median overall survival for all 24 patients was 10 months. Grade III/IV acute toxicity was seen in only one patient and no patient had any significant late morbidity. ReRT and HT is an effective and a safe modality to treat locoregional recurrences in previously irradiated breast cancers. The approach can lead to sustainable long-term palliation with minimal morbidity.
Highlights
Around one-third of breast cancer patients develop locoregional recurrences during their follow-up and more than 80% of the recurrences are known to occur within the first 5-years of their primary treatment [1, 2]
Grade III/IV acute toxicity was seen in only one patient and no patient had any significant late morbidity
Patient population Between 2006 and 2013, a total of 46 breast cancer patients with locoregional recurrences were referred to our institute for further management
Summary
Around one-third of breast cancer patients develop locoregional recurrences during their follow-up and more than 80% of the recurrences are known to occur within the first 5-years of their primary treatment [1, 2]. Mastectomy, considered a gold standard for treating recurrences after breast conservation, may result in a second local recurrence in 2% to 31% of patients [9] For those who had undergone mastectomy as part of their initial treatment, repeat surgery for recurrences provides local control in only one-third of the patients [10]. Hyperthermia (HT), at 41 to 43 °C, is a known radiosensitiser with minimal morbidity and enhances the efficacy of radiation through its unique thermoradiobiological properties [11, 12]. It complements the radiation-induced tumouricidal effects through hypoxic cell sensitisation and reduces
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
