Palliative Radiotherapy for Symptomatic Locally Advanced Breast Cancer

被引:0
作者
Hoeltgen, Line [1 ,2 ,3 ]
Meixner, Eva [1 ,2 ,3 ]
Hoegen, Philipp [1 ,2 ,3 ,4 ]
Sandrini, Elisabetta [1 ,2 ,3 ]
Weykamp, Fabian [1 ,2 ,3 ,4 ]
Forster, Tobias [1 ,2 ,3 ]
Vinsensia, Maria [1 ,2 ,3 ]
Lang, Kristin [1 ,2 ,3 ]
Koenig, Laila [1 ,2 ,3 ]
Arians, Nathalie [1 ,2 ,3 ]
Fremd, Carlo [3 ]
Michel, Laura L. [3 ]
Smetanay, Katharina [3 ,7 ]
Schneeweiss, Andreas [3 ]
Wallwiener, Markus [7 ]
Debus, Juergen [1 ,2 ,3 ,4 ,5 ,6 ]
Hoerner-Rieber, Juliane [1 ,2 ,3 ,4 ]
机构
[1] Heidelberg Univ Hosp, Dept Radiat Oncol, Heidelberg, Germany
[2] Heidelberg Inst Radiat Oncol HIRO, Heidelberg, Germany
[3] Natl Ctr Tumor Dis NCT, Heidelberg, Germany
[4] German Canc Res Ctr, Clin Cooperat Unit Radiat Oncol, Heidelberg, Germany
[5] Heidelberg Univ Hosp, Heidelberg Ion Beam Therapy Ctr HIT, Dept Radiat Oncol, Heidelberg, Germany
[6] German Canc Consortium DKTK, Partner Site Heidelberg, Heidelberg, Germany
[7] Heidelberg Univ Hosp, Dept Gynecol & Obstet, Heidelberg, Germany
关键词
palliative care; radiation therapy; LABC; exulceration; pain; hemorrhage;
D O I
暂无
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 degrees -II degrees ) 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.
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  • [11] Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Peritoneal Metastasis in Norway: Prognostic Factors and Oncologic Outcome in a National Patient Cohort
    Froysnes, Ida S.
    Larsen, Stein G.
    Spasojevic, Milan
    Dueland, Svein
    Flatmark, Kjersti
    [J]. JOURNAL OF SURGICAL ONCOLOGY, 2016, 114 (02) : 222 - 227
  • [12] Immunological metagene signatures derived from immunogenic cancer cell death associate with improved survival of patients with lung, breast or ovarian malignancies: A large-scale meta-analysis
    Garg, Abhishek D.
    De Ruysscher, Dirk
    Agostinis, Patrizia
    [J]. ONCOIMMUNOLOGY, 2016, 5 (02):
  • [13] QUANTIFICATION IN ENZYME-LINKED IMMUNOSORBENT-ASSAY OF A C-3 NEOEPITOPE EXPRESSED ON ACTIVATED HUMAN-COMPLEMENT FACTOR-C3
    GARRED, P
    MOLLNES, TE
    LEA, T
    [J]. SCANDINAVIAN JOURNAL OF IMMUNOLOGY, 1988, 27 (03) : 329 - 335
  • [14] Radiation safety considerations for the use of radium-224-calciumcarbonate-microparticles in patients with peritoneal metastasis
    Gronningsaeter, Simen Rykkje
    Blakkisrud, Johan
    Selboe, Silje
    Revheim, Mona-Elisabeth
    Bruland, Oyvind Sverre
    Bonsdorff, Tina Bjornlund
    Larsen, Stein Gunnar
    Stokke, Caroline
    [J]. FRONTIERS IN MEDICINE, 2023, 10
  • [15] Hallmarks of Cancer: The Next Generation
    Hanahan, Douglas
    Weinberg, Robert A.
    [J]. CELL, 2011, 144 (05) : 646 - 674
  • [16] IL-6 in inflammation, autoimmunity and cancer
    Hirano, Toshio
    [J]. INTERNATIONAL IMMUNOLOGY, 2021, 33 (03) : 127 - 148
  • [17] Effect of Perfusion Fluids on Recovery of Inflammatory Mediators in Microdialysis
    Khan, F.
    Pharo, A.
    Lindstad, J. K.
    Mollnes, T. E.
    Tonnessen, T. I.
    Pischke, S. E.
    [J]. SCANDINAVIAN JOURNAL OF IMMUNOLOGY, 2015, 82 (05) : 467 - 475
  • [18] The artificial surface-induced whole blood inflammatory reaction revealed by increases in a series of chemokines and growth factors is largely complement dependent
    Lappegard, K. T.
    Bergseth, G.
    Riesenfeld, J.
    Pharo, A.
    Magotti, P.
    Lambris, J. D.
    Mollnes, T. E.
    [J]. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART A, 2008, 87A (01) : 129 - 135
  • [19] Human genetic deficiencies reveal the roles of complement in the inflammatory network: Lessons from nature
    Lappegard, Knut Tore
    Christiansen, Dorte
    Pharo, Anne
    Thorgersen, Ebbe Billmann
    Hellerud, Bernt Christian
    Lindstad, Julie
    Nielsen, Erik Waage
    Bergseth, Grethe
    Fadnes, Dag
    Abrahamsen, Tore G.
    Hoiby, E. Arne
    Schejbel, Lone
    Garred, Peter
    Lambris, John D.
    Harboe, Morten
    Mollnes, Tom Eirik
    [J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2009, 106 (37) : 15861 - 15866
  • [20] Artificial surface-induced cytokine synthesis:: Effect of heparin coating and complement inhibition
    Lappegård, KT
    Fung, M
    Bergseth, G
    Riesenfeld, J
    Mollnes, TE
    [J]. ANNALS OF THORACIC SURGERY, 2004, 78 (01) : 38 - 45