Post-operative re-irradiation with hyperthermia in locoregional breast cancer recurrence: Temperature matters

被引：22

作者：

Bakker, Akke ^{[1
]}

Valverde, C. Paola Tello ^{[1
]}

van Tienhoven, Geertjan ^{[1
]}

Kolff, M. Willemijn ^{[1
]}

Kok, H. Petra ^{[1
]}

Slotman, Ben J. ^{[1
]}

Konings, Inge R. H. M. ^{[2
]}

Oei, Arlene L. ^{[1
,3
]}

Oldenburg, Hester S. A. ^{[4
]}

Rutgers, Emiel J. T. ^{[4
]}

Rasch, Coen R. N. ^{[5
]}

van den Bongard, H. J. G. Desiree ^{[1
]}

Crezee, Hans ^{[1
]}

机构：

[1] Univ Amsterdam, Ctr Expt & Mol Med, Canc Ctr Amsterdam, Amsterdam UMC,Dept Radiat Oncol, Amsterdam, Netherlands

[2] Univ Amsterdam, Ctr Expt & Mol Med, Canc Ctr Amsterdam, Amsterdam UMC,Dept Med Oncol, Amsterdam, Netherlands

[3] Univ Amsterdam, Ctr Expt & Mol Med, Canc Ctr Amsterdam, Amsterdam UMC,Lab Expt Oncol & Radiobiol, Amsterdam, Netherlands

[4] Netherlands Canc Inst, Dept Surg Oncol, Leiden, Netherlands

[5] LUMC, Dept Radiat Oncol, Leiden, Netherlands

来源：

RADIOTHERAPY AND ONCOLOGY | 2022年 / 167卷

关键词：

Locoregional recurrent breast cancer; Re-irradiation; Hyperthermia; Dose-effect relationship; Thermal dose; Locoregional control; Toxicity; Propensity score; Inverse probability weighting; RADIATION-THERAPY; REGIONAL HYPERTHERMIA; CHEST-WALL; RADIOTHERAPY; TUMOR; THERMORADIOTHERAPY; TRIALS; CELLS; APPLICATORS; OXYGENATION;

D O I：

10.1016/j.radonc.2021.12.036

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：149 / 157

页数：9

共 65 条

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