Local control rate after the combination of re-irradiation and hyperthermia for irresectable recurrent breast cancer: Results in 248 patients
Local control rate after the combination of re-irradiation and hyperthermia for irresectable recurrent breast cancer: Results in 248 patients
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DOI：
10.1016/j.radonc.2015.04.019
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发表时间：
2015-11-01
影响因子：
5.7
通讯作者：
van der Zee, Jacoba
中科院分区：
文献类型：
--
作者：
Linthorst, Marianne;Baaijens, Margreet;van der Zee, Jacoba
背景和目的：随机研究表明，在再照射（re-RT）基础上增加热疗（HT）可改善乳腺癌复发患者的治疗结果。我们评估的有效性和副作用，在患者治疗的re-RT和HT为不可切除的局部乳腺癌recurrification.Material和方法：从1996年9月至2011年12月，248例宏观乳腺癌复发的患者进行了治疗与re-RT和HT。放射治疗（RT）剂量为32戈伊，分4次戈伊，每周2次。RT后每周开一次HT。该分析的主要终点是完全缓解（CR）和局部控制（LC）。次要终点是总生存期（OS）和毒性。单变量和多变量分析确定了患者，肿瘤和治疗相关特征预测的终点。结果：中位随访期为32个月。CR率70%。1年、3年和5年时，LC分别为53%、40%和39%，OS分别为66%、32%和18%。10年后的OS为10%。23%的患者发生热烧伤，保守治疗后愈合。5年晚期3级毒性的发生率为1%。少数患者存活超过10年，没有证据diseases.Conclusions：再RT和HT的组合结果在一个长期的LC与可接受的晚期毒性率高，许多患者仍然在当地控制其生存期的其余部分。(C)2015爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: Randomized studies have shown that adding hyperthermia (HT) to re-irradiation (re-RT) improves treatment outcome for patients with breast cancer recurrences. We evaluated the efficacy and side effects in patients treated with re-RT and HT for irresectable locoregional breast cancer recurrences.Material and methods: From September 1996 to December 2011, 248 patients with a macroscopic breast cancer recurrence were treated with re-RT and HT. Radiotherapy (RT) was applied to a dose of 32 Gy in 4 Gy fractions, twice weekly. HT was prescribed once weekly after RT. Primary endpoints for this analysis were complete response (CR) and local control (LC). Secondary endpoints were overall survival (OS), and toxicity. Patient-, tumor-, and treatment-related characteristics predictive for the endpoints were identified in univariate and multivariate analyses.Results: The median follow-up period was 32 months. The CR rate was 70%. At 1, 3, and 5 years LC was 53%, 40% and 39%, and OS was 66%, 32%, and 18%, respectively. OS after 10 years was 10%. Thermal burn developed in 23% patients, healing with conservative measures. The incidence of 5 years late grade 3 toxicity was 1%. A few patients survived more than 10 years without evidence of disease.Conclusions: The combination of re-RT and HT results in a high rate of long-term LC with acceptable late toxicity, and many patients remained locally controlled for the rest of their survival period. (C) 2015 Elsevier Ireland Ltd. All rights reserved.