Reirradiation combined with hyperthermia in recurrent breast cancer results in a worthwhile local palliation

Abstract

Both experimental and clinical research have shown that hyperthermia (HT) gives valuable additional effects when applied in combination with radiotherapy (RT). The purpose of this study was evaluation of results in patients with recurrent breast cancer, treated at the Daniel den Hoed Cancer Center (DHCC) with reirradiation (re-RT; eight fractions of 4 Gy twice weekly) combined with HT. All 134 patients for whom such treatment was planned were included in the analysis. The complete response rate in 119 patients with macroscopic tumour was 71%. Including the 15 patients with microscopic disease, the local control rate was 73%. The median duration of local control was 32 months, and toxicity was acceptable. The complete response (CR) rate was higher, and the toxicity was less with the later developed 433-MHz HT technique compared with the 2450-MHz technique used initially. With this relatively well-tolerated treatment, palliation by local tumour control of a worthwhile duration is achieved in the majority of patients. The technique used for hyperthermia appeared to influence the achieved results. The value of HT in addition to this re-RT schedule has been confirmed by a prospective randomized trial in a similar patient group. In The Netherlands, this combined treatment is offered as standard to patients with breast cancer recurring in previously irradiated areas. © 1999 Cancer Research Campaign

Radiotherapy and Hyperthermia in the Treatment of Locoregional Recurrent Cancer-Report of the First Patients Treated in Portugal

“…The contribution of HT in combination with RT was confirmed by a randomized study from the International Collaborative Hyperthermia Group, in 1996 [5]. The J van der Zeel et al study reported a complete response rate of 71% with the same treatment scheme [1].…”

“…They are responsible for severe pain, with bleeding and/or local infection, in lesions which may vary in appearance. [1,2]. For the patient, noticing the visible uncontrolled tumoral growth with the above-mentioned characteristics, constitutes an extremely painful living experience, both physically and psychologically.…”

“…Radiotherapy, often regarded as the salvation therapy, when delivered in previously irradiated regions, can lead to an unacceptable level of local toxicity if effective doses are preconized [1][2][3][4].…”

Hyperthermia Is Now Included in the NCCN Clinical Practice Guidelines for Breast Cancer Recurrences: An Analysis of Existing Data

“…Van der Zee et al [26] ran a trial with 134 patients for the evaluation of this treatment. Hyperthermia was applied either with a 433 MHz technique or with a 2,450 MHz technique.…”

Current Treatment of Isolated Locoregional Breast Cancer Recurrences

“…Re-irradiation is used with caution due to an increased normal-tissue complication probability. Thus, only few series using EBRT alone [53,54,55] or in combination with hyperthermia for re-irradiation of the chest wall have been published so far [56,57,58,59,60,61]. Additionally, simultaneous radiochemotherapy as a further treatment option has been investigated in a limited number of trials [62,63,64].…”