title: Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall.
abstract: OBJECTIVE
  Radiation-induced angiosarcoma (RAS) of the chest wall/breast has a poor prognosis due to the high percentage of local failures. The efficacy and side effects of re-irradiation plus hyperthermia (reRT + HT) treatment alone or in combination with surgery were assessed in RAS patients.
  
  
  METHODS
  RAS was diagnosed in 23 breast cancer patients and 1 patient with melanoma. These patients had previously undergone breast conserving therapy (BCT, n = 18), mastectomy with irradiation (n=5) or axillary lymph node dissection with irradiation (n = 1). Treatment consisted of surgery followed by reRT + HT (n = 8), reRT + HT followed by surgery (n = 3) or reRT + HT alone (n = 13). Patients received a mean radiation dose of 35 Gy (32-54 Gy) and 3-6 hyperthermia treatments (mean 4). Hyperthermia was given once or twice a week following radiotherapy (RT).
  
  
  RESULTS
  The median latency interval between previous radiation and diagnosis of RAS was 106 months (range 45-212 months). Following reRT + HT, the complete response (CR) rate was 56 %. In the subgroup of patients receiving surgery, the 3-month, 1- and 3-year actuarial local control (LC) rates were 91, 46 and 46 %, respectively. In the subgroup of patients without surgery, the rates were 54, 32 and 22 %, respectively. Late grade 4 RT toxicity was seen in 2 patients.
  
  
  CONCLUSIONS
  The present study shows that reRT + HT treatment--either alone or combined with surgery--improves LC rates in patients with RAS.
authors.affiliation: Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC-Daniel den Hoed Cancer Center, 3008, Rotterdam, The Netherlands. m.linthorst@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Linthorst
authors.forename: A N
authors.initials: AN
authors.lastname: van Geel
authors.forename: E A
authors.initials: EA
authors.lastname: Baartman
authors.forename: S B
authors.initials: SB
authors.lastname: Oei
authors.forename: W
authors.initials: W
authors.lastname: Ghidey
authors.forename: G C
authors.initials: GC
authors.lastname: van Rhoon
authors.forename: J
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006394:Hemangiosarcoma / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000628:therapy*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D013899:Thoracic Neoplasms / Q000209:etiology / Q000628:therapy*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000528:radiation effects / Q000601:surgery; D016896:Treatment Outcome
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