Notter M, Thomsen AR, Nitsche M, Hermann RM, Wolff H, Habl G, Münch K, Grosu AL, Vaupel P published in cancers 2020, 12, 606 the evaluation of 201 patients with inoperable, locally recurrent breast cancer (LRBC) in a pre-irradiated area. Patients were treated from 2009 - 2019 in Hôpitale Cantonale La-Chaux-de-Fonds, Lindenhofspital Bern, University Medical Center Freiburg, Center of Radiotherapy and Radiooncology Bremen, and Radiology Munich (Strahlentherapie am Maximiliansplatz).

Thermography controlled wIRA superficial hyperthermia (45-60 minutes) was performed 1-4 minutes before hypofractionated radiotherapy of 5 treatments at 4 Gy, 1x/week.

Since the size of tumor is one of the most important prognostic factors, a novel size classification was used for evaluation:

Tumor response rates (CR=Complete Response, PR=Partial Response, NC=No Change, PD=Progressed Disease) were:

  • rClass I (Ø ≤10cm): CR 76%, PR 24%
  • rClass II (> 100 cm², ipsilateral): CR 61%, PR 36%, NC 3%
  • rClass III (contralateral): CR 36%, PR 61%, PD 2%
  • rClass IV (extension on the back, „cancer cuirasse“): CR 2%, PR 83%, NC 10%, PD 5%

Local control rate during lifetime was 67% in patients with CR, local progression-free rate during lifetime was 55% in patients with PR.

While compared to other clinical studies on HT/RT in LRBC, pre-irradiation dosage as well as the size of tumour lesions were highly above-average, the total re-irradiation dosage of 5 x 4 Gy = 20 Gy was the lowest dosage ever reported.

Side-effects were limited to acute toxicity of grade I and II, and only in few patients chronic side-effects of teleangiectasia and hyperpigmentation.

The low toxicity even allowed for the effective re-reirradiation of re-recurrences in the same region using the same protocol.

The publication including detailed analysis of patient characteristics, local control, survival and location as well as re-re-irradiation of re-recurrences, is fully available OPEN ACCESS https://www.mdpi.com/2072-6694/12/3/606

 

 

 

 

 

 

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