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. 2010 Dec;97(3):535-40.
doi: 10.1016/j.radonc.2010.10.020. Epub 2010 Nov 11.

Durable palliation of breast cancer chest wall recurrence with radiation therapy, hyperthermia, and chemotherapy

Timothy M Zagar  1 , Kristin A Higgins, Edward F Miles, Zeljko Vujaskovic, Mark W Dewhirst, Robert W Clough, Leonard R Prosnitz, Ellen L Jones
Affiliations

Durable palliation of breast cancer chest wall recurrence with radiation therapy, hyperthermia, and chemotherapy

Timothy M Zagar et al. Radiother Oncol. 2010 Dec.

Abstract

Background and purpose: Chest wall recurrences of breast cancer are a therapeutic challenge and durable local control is difficult to achieve. Our objective was to determine the local progression free survival (LPFS) and toxicity of thermochemoradiotherapy (ThChRT) for chest wall recurrence.

Methods: Twenty-seven patients received ThChRT for chest wall failure from 2/1995 to 6/2007 and make up this retrospective series. All received concurrent superficial hyperthermia twice weekly (median 8 sessions), chemotherapy (capecitabine in 21, vinorelbine in 2, and paclitaxel in 4), and radiation (median 45 Gy). Patients were followed up every 1.5-3 months and responses were graded with RECIST criteria and toxicities with the NCI CTC v4.0.

Results: Twenty-three (85%) patients were previously irradiated (median 60.4 Gy) and 22 (81%) patients received prior chemotherapy. Median follow-up was 11 months. Complete response (CR) was achieved in 16/20 (80%) of patients with follow-up data, and 1 year LPFS was 76%. Overall survival was 23 months for patients with CR, and 5.4 months in patients achieving a partial response (PR) (p=0.01). Twenty-two patients experienced acute grade 1/2 treatment related toxicities, primarily moist desquamation. Two patients experienced 3rd degree burns; all resolved with conservative measures.

Conclusions: ThChRT offers durable palliation and prolonged LPFS with tolerable acute toxicity, especially if CR is achieved.

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Conflict of interest statement

Conflicts of interest statement

E.L. Jones, M.D., Ph.D., on speaker’s bureau and consultant, BSD Medical; M.W. Dewhirst is a paid consultant and Chair of the Scientific Advisory Board of Celsion, Inc., and is recipient of research contracts from Varian Corporation and GlaxoSmithKline, Inc., M.W.D. and V.J. are recipients of grants from the National Institutes of Health; all other authors had none.

Durable palliation of breast cancer chest wall recurrence with radiation therapy, hyperthermia, and chemotherapy is an approved Duke University Protocol, #00003793.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government.

For CDR Edward F. Miles—I am a military service member. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties.

Figures

Fig. 1
Fig. 1
(a) Local progression-free survival for all patients (b) overall survival for all patients; (c) and for patients with CR versus PR.
See this image and copyright information in PMC

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