Hyperthermia and radiation therapy for locally advanced or recurrent breast cancer

Publishing house: The Breast
Main author: Tamer Refaat
Other authors: Sean Sachdev, Vythialinga Sathiaseelan, Irene Helenowski, Salah Abdelmoneim, Margaret C. Pierce, Gayle Woloschak, William Small Jr., Bharat Mittal, Krystyna D. Kiel
Date: 2015-04-18

DOI: 10.1016/j.breast.2015.03.008 0960-9776/

Language: english

Publication class: Retrospective study

Research type: Non randomized, single-phase

Number of patients: 127

HT type: LRHT RF

Description of HT type: Local HT, superficial, radio waves

Device: BSD-500

Disease entity: Locally advanced or recurrent breast cancer

Symbol of disease entity: LABC

Stage: –

Types of combination with HT: HT+RT

CT type:  N/A

Abstract. Background: 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 1.8e2 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 ¼ 0.003), and local control (p ¼ 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 ¼ 0.002) and median TED 43  C   100 min (p ¼ 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.

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