Hyperthermia combined with radiation therapy in the treatment of local recurrent breast cancer.
BACKGROUND
Hyperthermia combined with radiation therapy was shown to be more effective in local recurrent breast cancer than radiotherapy alone, but its use is limited due to technical difficulties, stringent reimbursement policies and because it is time consuming.


OBJECTIVE
To report our experience with a simple and convenient XRT + HT delivery system.


METHODS
XRT was delivered through either electron or photon beams (total dose 30-40 Gy in previously irradiated fields or 50-70 Gy in non-irradiated fields). Hyperthermia was delivered by a dedicated HT device operating at 915 MHz. The heating session lasted 45 minutes. The maximal tumor surface temperature was set at 45 degrees C and modified according to patient comfort. No intratumoral (invasive) thermometry was used. At least two HT sessions were scheduled to each HT field during the entire XRT treatment period. Tumor response was evaluated every 3 months after completion of treatment. The overall survival was measured from XRT + HT initiation until the last follow-up.


RESULTS
Fifteen women underwent 114 HT treatments delivered through 28 HT fields. Twenty-four HT fields (15 patients) were previously irradiated. There was complete infield response in 10 fields (6 patients), partial response in 8 fields (4 patients), no response or progressive disease in 4 fields (3 patients), and no parameters in 6 fields (5 patients). Eighteen fields (64%) had complete or partial response. Seven patients had outfield recurrence despite wide XRT + HT fields. Ulceration was the only major side effect (three patients, three fields).


CONCLUSIONS
The combined HT+XRT delivery system, with no invasive thermometry, is a simple and effective method for treating local recurrent breast cancer.
Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. rby@tasmc.health.gov.il
Rami
R
Ben-Yosef
Nili
N
Vigler
Moshe
M
Inbar
Akiva
A
Vexler
D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods*; D016896:Treatment Outcome