Hyperthermia and radiation therapy for locally advanced or recurrent breast cancer

Tamer Refaat, Sean Sachdev, Vythialinga Sathiaseelan, Irene Helenowski, Salah Abdelmoneim, Margaret C. Pierce, Gayle Woloschak, William Small, Bharat Mittal, Krystyna D. Kiel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Introduction: This study aims to report the outcome and toxicity of combined hyperthermia (HT) and radiation therapy (RT) in treatment of locally advanced or loco-regionally recurrent breast cancer. Patients and Methods: Patients treated with HT and RT from January 1991 to December 2007 were reviewed. RT doses for previously irradiated patients were > 40 Gy and for RT naïve patients > 60 Gy, at 1.8-2 Gy/day. HT was planned for 2 sessions/week, immediately after RT, for a minimum of 20 min and for > 4 sessions. Superficial or interstitial applicators were used with temperature measured by superficial or interstitial thermistors based on target thickness. HT treatment was assessed by thermal equivalent dose (TED), > 42.5 °C and > 43 °C. Endpoints included treatment response, lack of local progression (local control), and survival. Results: 127 patients received HT and RT to 167 sites. These included the intact breast (24.4%), chest wall/skin (67.7%), and breast/chest wall and nodes (7.9%). At a median follow-up of 13 months (mean 30 ± 38), improved overall survival was significantly associated with increasing RT dose (p < 0.0001), median TED 42.5 °C ≥ 200 min (p = 0.003), and local control (p = 0.0002). Local control at last follow-up was seen in 55.1% of patients. Complete response was significantly associated with median TED 42.5 °C ≥ 200 min (p = 0.002) and median TED 43 °C ≥ 100 min (p = 0.03). Conclusion: HT and RT are effective for locally advanced or recurrent breast cancer in patients that have been historically difficult to treat by RT alone. Over 50% of patients achieved control of locoregional disease. Overall survival was improved with local control.

Original languageEnglish (US)
Pages (from-to)418-425
Number of pages8
JournalBreast
Volume24
Issue number4
DOIs
StatePublished - Aug 1 2015

Keywords

  • Breast cancer
  • Hyperthermia
  • Locally advanced
  • Locoregional recurrence
  • Radiation therapy
  • Reirradiation

ASJC Scopus subject areas

  • Surgery

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