Post-operative re-irradiation with hyperthermia in locoregional breast cancer recurrence
| Autor: | Akke Bakker, C. Paola Tello Valverde, Geertjan van Tienhoven, M. Willemijn Kolff, H. Petra Kok, Ben J. Slotman, Inge R.H.M. Konings, Arlene L. Oei, Hester S.A. Oldenburg, Emiel J.T. Rutgers, Coen R.N. Rasch, H.J.G. Desirée van den Bongard, Hans Crezee |
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| Přispěvatelé: | Radiotherapy, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, CCA - Cancer biology and immunology, AII - Cancer immunology, Center of Experimental and Molecular Medicine, Radiation Oncology, CCA - Cancer Treatment and quality of life, Internal medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Male
Dose-effect relationship Locoregional control Toxicity Propensity score Temperature Breast Neoplasms Hyperthermia Induced Hematology Combined Modality Therapy Oncology Humans Female Radiology Nuclear Medicine and imaging Re-irradiation Hyperthermia Neoplasm Recurrence Local Thermal dose Inverse probability weighting Retrospective Studies Locoregional recurrent breast cancer |
| Zdroj: | Bakker, A, Tello Valverde, C P, van Tienhoven, G, Kolff, M W, Kok, H P, Slotman, B J, Konings, I R H M, Oei, A L, Oldenburg, H S A, Rutgers, E J T, Rasch, C R N, van den Bongard, H J G D & Crezee, H 2022, ' Post-operative re-irradiation with hyperthermia in locoregional breast cancer recurrence : Temperature matters ', Radiotherapy and Oncology, vol. 167, pp. 149-157 . https://doi.org/10.1016/j.radonc.2021.12.036 Radiotherapy & Oncology, 167, 149-157. ELSEVIER IRELAND LTD Radiotherapy and oncology, 167(149-157), 149-157. Elsevier Ireland Ltd Radiotherapy and Oncology, 167, 149-157. Elsevier Ireland Ltd |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2021.12.036 |
| Popis: | Purpose: To investigate the impact of hyperthermia thermal dose (TD) on locoregional control (LRC), overall survival (OS) and toxicity in locoregional recurrent breast cancer patients treated with postoperative re-irradiation and hyperthermia.Methods: In this retrospective study, 112 women with resected locoregional recurrent breast cancer treated in 2010-2017 with postoperative re-irradiation 8frx4Gy (n = 34) or 23frx2Gy (n = 78), combined with 4-5 weekly hyperthermia sessions guided by invasive thermometry, were subdivided into 'low' (n = 56) and 'high' TD (n = 56) groups by the best session with highest median cumulative equivalent minutes at 43 degrees C (Best CEM43T50) < 7.2 min and >7.2 min, respectively. Actuarial LRC, OS and late toxicity incidence were analyzed. Backward multivariable Cox regression and inverse probability weighting (IPW) analysis were performed.Results: TD subgroups showed no significant differences in patient/treatment characteristics. Median follow-up was 43 months (range 1-107 months). High vs. low TD was associated with LRC (p = 0.0013), but not with OS (p = 0.29) or late toxicity (p = 0.58). Three-year LRC was 74.0% vs. 92.3% in the low and high TD group, respectively (p = 0.008). After three years, 25.0% and 0.9% of the patients had late toxicity grade 3 and 4, respectively. Multivariable analysis showed that distant metastasis (HR 17.6; 95%CI 5.2-60.2), lymph node involvement (HR 2.9; 95%CI 1.2-7.2), recurrence site (chest wall vs. breast; HR 4.6; 95%CI 1.8-11.6) and TD (low vs. high; HR 4.1; 95%CI 1.4-11.5) were associated with LRC. TD was associated with LRC in IPW analysis (p = 0.0018).Conclusions: High thermal dose (best CEM43T50 >= 7.2 min) was associated with significantly higher LRC for patients with locoregional recurrent breast cancer treated with postoperative re-irradiation and hyperthermia, without augmenting toxicity. (C) 2021 The Authors. Published by Elsevier B.V. |
| Databáze: | OpenAIRE |
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