Palliative Radiotherapy for Symptomatic Locally Advanced Breast Cancer.

Autor:	Hoeltgen L; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Meixner E; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Hoegen P; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Sandrini E; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Weykamp F; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Forster T; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Vinsensia M; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Lang K; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., König L; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Arians N; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Fremd C; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Michel LL; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Smetanay K; National Center for Tumor Diseases (NCT), Heidelberg, Germany.; Department of Gynecology and Obstetrics, 27178Heidelberg University Hospital, Heidelberg, Germany., Schneeweiss A; National Center for Tumor Diseases (NCT), Heidelberg, Germany., Wallwiener M; Department of Gynecology and Obstetrics, 27178Heidelberg University Hospital, Heidelberg, Germany., Debus J; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Department of Radiation Oncology, Heidelberg Ion Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany.; German Cancer Consortium (DKTK), Partner Site Heidelberg, Heidelberg, Germany., Hörner-Rieber J; Department of Radiation Oncology, 27178Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor Diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Technology in cancer research & treatment [Technol Cancer Res Treat] 2023 Jan-Dec; Vol. 22, pp. 15330338231164537.
DOI:	10.1177/15330338231164537
Abstrakt:	Objective: Women with locally advanced breast cancer (LABC) or inoperable local recurrence often suffer from a significantly reduced quality of life (QOL) due to local tumor-associated pain, bleeding, exulceration, or malodorous discharge. We aimed to further investigate the benefit of radiotherapy (RT) for symptom relief while weighing the side-effects. Materials and methods: Patients who received symptom-oriented RT for palliative therapy of their LABC or local recurrence in the Department of Radiation Oncology at Heidelberg University Hospital between 2012 and 2021 were recorded. Clinical, pathological, and therapeutic data were collected and the oncological and symptomatic responses as well as therapy-associated toxicities were analyzed. Results: We retrospectively identified 26 consecutive women who received palliative RT with a median total dose of 39 Gy or single dose of 3 Gy in 13 fractions due to (impending) exulceration, pain, local hemorrhage, and/or vascular or plexus compression. With a median follow-up of 6.5 months after initiation of RT, overall survival at 6 and 12 months was 60.0% and 31.7%, and local control was 75.0% and 47.6%, respectively. Radiation had to be discontinued in 4 patients due to oncological clinical deterioration or death. When completed as initially planned, symptom improvement was achieved in 95% and WHO level reduction of analgesics in 28.6% of patients. In 36% (16%) of patients, local RT had already been indicated >3 months (>6 months) before the actual start of RT, but was delayed or not initiated among others in favor of drug alternatives or systemic therapies. RT-associated toxicities included only low-grade side-effects (CTCAE I°-II°) with predominantly skin erythema and fatigue even in the context of re-RT. Conclusion: Palliative RT in symptomatic LABC or locoregional recurrence is an effective treatment option for controlling local symptoms with only mild toxicity. It may thus improve QOL and should be considered early in palliative patient care management.
Databáze:	MEDLINE
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