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Open AccessArticle

Combined wIRA-Hyperthermia and Hypofractionated Re-Irradiation in the Treatment of Locally Recurrent Breast Cancer: Evaluation of Therapeutic Outcome Based on a Novel Size Classification

1
Department of Radiation Oncology, Lindenhofspital Bern, 3012 Bern, Switzerland
2
Department of Radiation Oncology, Medical Center, University of Freiburg, 79106 Freiburg, Germany
3
German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
4
Center for Radiotherapy and Radiooncology Bremen and Westerstede, 28239 Bremen, Germany
5
Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, 80333 Munich, Germany
6
Department of Radiation Oncology, Medical Center, University of Regensburg, 93053 Regensburg, Germany
7
Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(3), 606; https://doi.org/10.3390/cancers12030606
Received: 24 January 2020 / Revised: 2 March 2020 / Accepted: 3 March 2020 / Published: 6 March 2020
(This article belongs to the Special Issue Hyperthermia-based Anticancer Treatments)
Effective tumor control in patients suffering from unresectable locally recurrent breast cancer (LRBC) in pre-irradiated areas can be achieved by re-irradiation combined with superficial hyperthermia. Using this combined modality, total re-irradiation dose and toxicity can be significantly reduced compared to conventionally fractionated treatment schedules with total doses of 60–66 Gy. Applying contact-free, thermography-controlled water-filtered infrared-A superficial hyperthermia, immediately followed by hypofractionated re-irradiation, consisting of 4 Gy once per week up to a total dose of 20 Gy, resulted in high overall response rates even in large-sized tumors. Comparability of clinical data between different combined Hyperthermia (HT)/Radiotherapy (RT) treatment schedules is impeded by the highly individual characteristics of this disease. Tumor size, ranging from microscopic disease and small lesions to large-sized cancer en cuirasse, is described as one of the most important prognostic factors. However, in clinical studies and analyses of LRBC, tumor size has so far been reported in a very heterogeneous way. Therefore, we suggest a novel, simple and feasible size classification (rClasses 0–IV). Applying this classification for the evaluation of 201 patients with pre-irradiated LRBC allowed for a stratification into distinct prognostic groups. View Full-Text
Keywords: locally recurrent breast cancer; LRBC; novel size classification; wIRA hyperthermia; superficial hyperthermia; re-irradiation; clinical outcome; toxicity locally recurrent breast cancer; LRBC; novel size classification; wIRA hyperthermia; superficial hyperthermia; re-irradiation; clinical outcome; toxicity
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Notter, M.; Thomsen, A.R.; Nitsche, M.; Hermann, R.M.; Wolff, H.A.; Habl, G.; Münch, K.; Grosu, A.-L.; Vaupel, P. Combined wIRA-Hyperthermia and Hypofractionated Re-Irradiation in the Treatment of Locally Recurrent Breast Cancer: Evaluation of Therapeutic Outcome Based on a Novel Size Classification. Cancers 2020, 12, 606.

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