| Popis: |
Unresectable locally recurrent breast cancers (LRBCs) lead to life-threatening situations and a tremendous loss of quality of life. Most patients have received radiotherapy (RT) during primary treatment and re-irradiation (re-RT) using standard doses might be denied due to the risk of unacceptable cumulative toxicity. Therefore, an effective tumor control is often abandoned.Mild hyperthermia (39–43 °C), allows for significant reductions in re-RT dose and effective tumor responses with acceptable toxicity even after heavy pretreatment. More than 280 patients have been treated with superficial hyperthermia by water-filtered infrared A (wIRA-HT), which can cover even large lesions. Hyperthermia was immediately followed by hypofractionated re-RT of 5x4 Gy, once a week.Evaluating 201 patients, overall response rate was 94%. 170 patients with macroscopic LRBC were stratified into 4 size classes (rClasses), and detailed response rates are presented. Accordingly, response rates of 31 patients with microscopic disease after resection of LRBC are communicated.RT-related acute and late toxicity was limited to grades 1 and 2. Due to this low toxicity, re-recurrences after CR and new local progression after PR could be re-treated using the same treatment schedule. Real-time thermographic and visual controls have allowed to almost exclude the risk of thermal skin damage. |
