Radiotherapy in the treatment of locoregional relapses of breast cancer
| Autor: | Stefan Hesselmann, N. Willich, O Micke, G Reinartz, C. Rübe, B Matthees, Andreas Schuck, Stefan Könemann, Ulrich Schäfer |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis medicine.medical_treatment Mammary gland Breast Neoplasms Disease Modified Radical Mastectomy Breast cancer Humans Medicine Radiology Nuclear Medicine and imaging Mastectomy Retrospective Studies business.industry Rate control Radiotherapy Dosage General Medicine medicine.disease Combined Modality Therapy Surgery Survival Rate Radiation therapy medicine.anatomical_structure Regression Analysis Female Neoplasm Recurrence Local business Complication Follow-Up Studies |
| Zdroj: | The British Journal of Radiology. 75:663-669 |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.75.896.750663 |
| Popis: | Locoregional recurrences of breast cancer are associated with considerable morbidity and frequently present with concurrent metastatic disease. Yet patients without systemic spread can be treated with curative intent. In a retrospective analysis, the results of treatment of these patients have been evaluated at our institution. Between 1987 and 1996, 113 patients with loco- regional breast cancer relapse, without systemic manifestation, received irradiation after local tumour excision. 13 patients (11.5%) had already received radiotherapy as part of their primary treatment. In these cases, only the area involved was treated. In all other patients, the chest wall and the ipsilateral lymph nodes were irradiated. Median dose was 50 Gy (range 20-65 Gy). Median follow-up was 4.4 years. 76 patients (67.3%) presented with chest wall recurrence only, 25 patients (22.1%) with nodal relapse only and 12 patients (10.6%) with combined relapses. 93% of patients had local control of disease after treatment. Local control rate after 5 years was 59%. 63 patients (55.8%) died within the follow-up interval, 45 patients (39.8%) owing to metastases, 4 patients (3.5%) owing to local failure and 8 patients (7%) owing to causes unrelated to tumour. Overall survival after 5 years was 43%. In multivariate analysis, positive hormone receptor status, small tumours on relapse and chest wall relapses alone were associated with improved survival. Radical local therapy is necessary in order to achieve and maintain local control and to prevent secondary dissemination in patients with only local recurrence of breast cancer. With either breast conserving therapy, includ- ing post-operative radiotherapy or modified radical mastectomy, the local relapse rates after 5 years are approximately 5-10%, although local recurrence can be as high as 30% in high-risk patients (1-3). Although purely locoregional fail- ures can be treated with curative intent, morbidity of local relapse is considerable and often accom- panied or followed by systemic failure (4-8). The goal of local treatment is to avoid further local relapse and to prevent secondary dissemination in patients who have not developed systemic spread (9-12). In this retrospective analysis, the outcome of patients with locoregional relapse of breast cancer has been evaluated. |
| Databáze: | OpenAIRE |
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