Reirradiation and hyperthermia for irresectable locoregional recurrent breast cancer in previously irradiated area: Size matters
Reirradiation and hyperthermia for irresectable locoregional recurrent breast cancer in previously irradiated area: Size matters
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DOI：
10.1016/j.radonc.2015.10.017
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发表时间：
2015-11-01
影响因子：
5.7
通讯作者：
van Tienhoven, Geertjan
中科院分区：
文献类型：
--
作者：
Oldenborg, Sabine;Griesdoorn, Vanessa;van Tienhoven, Geertjan
背景/目的：在以前照射过的区域不能切除的局部复发性乳腺癌的治疗选择是有限的。热疗，将肿瘤温度升高到40-45摄氏度，使放射和化学疗法敏感。414例患者治疗再放疗+热疗（reRT + HT）在AMC（（n=301））和BVI（n=113），从1982年至2005年进行了回顾性分析治疗反应，局部控制（LC）和预后因素LC和toxicity.Patients/方法：所有患者接受了以前的照射（中位数50戈伊）。reRT包括8 x 4戈伊-2/周（AMC）或12 x 3戈伊-4/周（BVI）。每周增加一次（AMC）/两次（BVI）热疗。结果：总体临床有效率为86%。3年LC率为25%。复发次数、远处转移（DM）、肿瘤部位、肿瘤大小、复发时间和治疗年对LC有显著性意义。24%的患者发生急性>= 3级毒性。在3年时，精算晚期>= 3级毒性为23%。在多变量分析中，reRT分次剂量与晚期>= 3级毒性显著相关。结论：reRT + HT是一种有效的治疗和姑息治疗选择，对患者不可切除的局部复发性乳腺癌在以前的照射区域。早期转诊，治疗胸壁复发
Background/purpose: Treatment options for irresectable locoregional recurrent breast cancer in previously irradiated area are limited. Hyperthermia, elevating tumor temperature to 40-45 degrees C, sensitizes radio-and-chemotherapy. Four hundred and fourteen patients treated with reirradiation + hyperthermia (reRT + HT) in the AMC((n=301)) and the BVI(n=113), from 1982 to 2005 were retrospectively analyzed for treatment response, locoregional control (LC) and prognostic factors for LC and toxicity.Patients/methods: All patients received previous irradiation (median 50 Gy). reRT consisted of 8 x 4 Gy-2/week (AMC) or 12 x 3 Gy-4/week (BVI). Hyperthermia was added once (AMC)/twice (BVI) a week.Results: Overall clinical response rate was 86%. The 3-year LC rate was 25%. The number of recurrence episodes, distant metastases (DM), tumor site, tumor size, time to recurrence and treatment year were significant for LC. Acute >= grade 3 toxicity occurred in 24% of patients. Actuarial late >= grade 3 toxicity was 23% at 3-years. In multivariable analysis reRT fraction dose was significantly related to late >= grade 3 toxicity.Conclusion: reRT + HT is an effective curative and palliative treatment option for patients with irresectable locoregional recurrent breast cancer in previously irradiated area. Early referral, treatment of chest wall recurrences