Hyperthermia and radiation therapy for locally advanced or recurrent breast cancer.
Hyperthermia and radiation therapy for locally advanced or recurrent breast cancer.
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DOI：
10.1016/j.breast.2015.03.008
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发表时间：
2015-08
期刊：
影响因子：
--
通讯作者：
Kiel KD
中科院分区：
文献类型：
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作者：
Refaat T;Sachdev S;Sathiaseelan V;Helenowski I;Abdelmoneim S;Pierce MC;Woloschak G;Small W Jr;Mittal B;Kiel KD
本研究旨在报告热疗（HT）联合放射治疗（RT）治疗局部晚期或局部复发性乳腺癌的疗效和毒性。回顾了1991年1月至2007年12月接受HT和RT治疗的患者。既往接受过放疗的患者的RT剂量>40戈伊，初次接受RT的患者的RT剂量>60戈伊，为1.8-2戈伊/天。HT计划每周2次，RT后立即进行，至少20分钟，>4次。使用表面或间隙施源器，基于目标厚度通过表面或间隙热敏电阻测量温度。HT处理通过热等效剂量（TED）、>42.5°C和>43°C来评估。终点包括治疗反应、缺乏局部进展（局部控制）和生存期。127例患者在167个部位接受了HT和RT。其中包括完整乳房（24.4%）、胸壁/皮肤（67.7%）和乳房/胸壁和结节（7.9%）。在中位随访13个月（平均30±38）时，总生存率的改善与RT剂量的增加（p<0.0001）、中位TED 42.5°C≥200分钟（p=0.003）和局部控制（p=0.0002）显著相关。末次随访时，55.1%的患者局部控制。完全缓解与中位TED 42.5°C≥200分钟（p=0.002）和中位TED 43°C≥100分钟（p=0.03）显著相关。HT和RT对局部晚期或复发性乳腺癌患者有效，这些患者历史上难以单独接受RT治疗。超过50%的患者局部疾病得到控制。局部控制改善了总生存率。
This study aims to report the outcome and toxicity of combined hyperthermia (HT) and radiation therapy (RT) in treatment of locally advanced or loco-regionally recurrent breast cancer. Patients treated with HT and RT from January 1991 to December 2007 were reviewed. RT doses for previously irradiated patients were >40 Gy and for RT naïve patients >60 Gy, at 1.8–2 Gy/day. HT was planned for 2 sessions/week, immediately after RT, for a minimum of 20 minutes and for >4 sessions. Superficial or interstitial applicators were used with temperature measured by superficial or interstitial thermisters based on target thickness. HT treatment was assessed by thermal equivalent dose (TED), >42.5°C and >43°C. Endpoints included treatment response, lack of local progression (local control), and survival. 127 patients received HT and RT to 167 sites. These included the intact breast (24.4%), chest wall/skin (67.7%), and breast/chest wall and nodes (7.9%). At a median follow-up of 13 months (mean 30±38), improved overall survival was significantly associated with increasing RT dose (p<0.0001), median TED 42.5°C≥200 minutes (p=0.003), and local control (p=0.0002). Local control at last follow-up was seen in 55.1% of patients. Complete response was significantly associated with median TED 42.5°C≥200 minutes (p=0.002) and median TED 43°C≥100 minutes (p=0.03). HT and RT are effective for locally advanced or recurrent breast cancer in patients that have been historically difficult to treat by RT alone. Over 50% of patients achieved control of locoregional disease. Overall survival was improved with local control.