April 11, 2005
Thermoradiotherapy of the chest wall in locally advanced or recurrent breast cancer with marginal resectionTopics: Thermoradiotherapy
Of interest to patients:
Hyperthermia is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 113°F) to damage and kill cancer cells. It is almost always used with other forms of cancer therapy, such as radiation therapy and chemotherapy. Several methods of hyperthermia are currently used, including local, regional, and whole-body hyperthermia. Many clinical trials (research studies) are being conducted to evaluate the effectiveness of hyperthermia. Most normal tissues are not damaged during hyperthermia if the temperature remains under 111°F. However, due to regional differences in tissue characteristics, higher temperatures may occur in various spots.
An evaluation of the efficacy of combined hyperthermia and radiotherapy (TRT) in high-risk breast cancer patients with microscopic involved margins (R1) after mastectomy or with resected locoregional, early recurrence with close margins or R1-resection, was undertaken at the Department of Radiation Oncology, Eberhard-Karls-Universitat Tubingen, Tubingen, Germany. The main endpoint of the study was local tumour control; secondary endpoints were overall survival, disease free survival and acute toxicity.
The study involved fifty patients being treated with thermoradiotherapy. Thirteen patients (group 1) received a post-operative TRT in a high-risk situation (free margin <1 cm or R1, N+), 37 patients (group 2) received TRT after close/R1 resection of a locoregional recurrence. Thirteen out of 37 patients in group 2 already had had two-to-seven recurrences prior to thermoradiotherapy. Median radiation dose was 60 Gy (range: 44-66.4 Gy), the additional local hyperthermia (>41 degrees C, 60 min) was given twice a week. Median follow-up for patients at risk was 28 months. Actuarial overall survival for all patients at 3 years accounted for 89%, disease free survival for 68% and local tumor control for 80%. Actuarial overall survival was 90% for group 1 and 89% for group 2, with four patients having died so far. Disease free survival at 3 years was 64% in group 1 and 69% in group 2, actuarial 3 year local tumor control was 75% and 81%, respectively. For patients with recurrent chest wall disease, there was no difference concerning local control between patients who underwent thermoradiotherapy with or without prior radiation.
The combined modality treatment was well tolerated. No grade IV toxicity(using Common Toxicity Criteria)occured. The results concerning local tumour control and overall survival in these high-risk patients were promising, especially for thermoradiotherapy for the treatment of local recurrences. A longer follow-up is suggested in order to estimate late toxicity.
Journal Source: Int J Hyperthermia. 2005 Mar;21(2):159-67.
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Posted by Richard at April 11, 2005 2:33 PM
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