title: Local control rate after the combination of re-irradiation and hyperthermia for irresectable recurrent breast cancer: Results in 248 patients.
abstract: OBJECTIVE
  Randomized studies have shown that adding hyperthermia (HT) to re-irradiation (re-RT) improves treatment outcome for patients with breast cancer recurrences. We evaluated the efficacy and side effects in patients treated with re-RT and HT for irresectable locoregional breast cancer recurrences.
  
  
  METHODS
  From September 1996 to December 2011, 248 patients with a macroscopic breast cancer recurrence were treated with re-RT and HT. Radiotherapy (RT) was applied to a dose of 32 Gy in 4 Gy fractions, twice weekly. HT was prescribed once weekly after RT. Primary endpoints for this analysis were complete response (CR) and local control (LC). Secondary endpoints were overall survival (OS), and toxicity. Patient-, tumor-, and treatment-related characteristics predictive for the endpoints were identified in univariate and multivariate analyses.
  
  
  RESULTS
  The median follow-up period was 32 months. The CR rate was 70%. At 1, 3, and 5 years LC was 53%, 40% and 39%, and OS was 66%, 32%, and 18%, respectively. OS after 10 years was 10%. Thermal burns developed in 23% patients, healing with conservative measures. The incidence of 5 years late grade 3 toxicity was 1%. A few patients survived more than 10 years without evidence of disease.
  
  
  CONCLUSIONS
  The combination of re-RT and HT results in a high rate of long-term LC with acceptable late toxicity, and many patients remained locally controlled for the rest of their survival period.
authors.affiliation: Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. Electronic address: m.linthorst@erasmusmc.nl.
authors.forename: Marianne
authors.initials: M
authors.lastname: Linthorst
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Baaijens
authors.affiliation: Department of Radiation Oncology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Ruud
authors.initials: R
authors.lastname: Wiggenraad
authors.affiliation: Department of Radiation Oncology, Leiden University Medical Center, The Netherlands.
authors.forename: Carien
authors.initials: C
authors.lastname: Creutzberg
authors.affiliation: HOVON Data Center, Erasmus MC-Clinical Trial Center, Rotterdam, The Netherlands.
authors.forename: Wendimagegn
authors.initials: W
authors.lastname: Ghidey
authors.affiliation: Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Gerard C
authors.initials: GC
authors.lastname: van Rhoon
authors.affiliation: Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Jacoba
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D015994:Incidence; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D000069475:Re-Irradiation / Q000379:methods*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Breast cancer recurrence; Complete response; Hyperthermia; Local control; Re-irradiation; Toxicity