PURPOSE: In vitro data demonstrate that heat-induced radiosensitisation is maximised if hyperthermia and radiotherapy are given simultaneously, with the radiation fraction delivered midway through a hyperthermia session, rather than sequentially. The long-term normal tissue toxicity of full-dose simultaneous thermoradiotherapy is unknown. MATERIALS AND METHODS: Patients with locally advanced breast cancer (T3, T4 or more than three involved nodes or local recurrence), no prior radiotherapy, received between four and eight sessions of simultaneous thermoradiotherapy. Hyperthermia always included the primary tumour site. In addition an electively heated sector (EHS) was included. The EHS was randomised to either medial or lateral to the tumour site, with the other side an irradiated but unheated control. As per our usual practice, patients received surgery and/or chemotherapy prior to radiotherapy. Radiation doses were 46-50 Gy followed by a boost of ≤16 Gy at 1.8-2 Gy per fraction. EHS and control sectors received the same dose. RESULTS: A total of 57 evaluable cases with average follow-up of 79 months experienced two local and two nodal recurrences. There was no significant difference in ≥grade 2 toxicity for heated versus control sectors (LR χ(2 )= 0.78, p = 0.38) with no relationship between number of hyperthermia sessions and toxicity (LR χ(2 )= 2.90, p = 0.09). CONCLUSIONS: Simultaneous full-dose thermoradiotherapy for breast cancer is feasible and well tolerated, with no significant difference in late toxicity between electively heated and unheated control sectors. All patients had hyperthermia to the primary tumour site with excellent local control.
RCT Entities:
PURPOSE: In vitro data demonstrate that heat-induced radiosensitisation is maximised if hyperthermia and radiotherapy are given simultaneously, with the radiation fraction delivered midway through a hyperthermia session, rather than sequentially. The long-term normal tissue toxicity of full-dose simultaneous thermoradiotherapy is unknown. MATERIALS AND METHODS:Patients with locally advanced breast cancer (T3, T4 or more than three involved nodes or local recurrence), no prior radiotherapy, received between four and eight sessions of simultaneous thermoradiotherapy. Hyperthermia always included the primary tumour site. In addition an electively heated sector (EHS) was included. The EHS was randomised to either medial or lateral to the tumour site, with the other side an irradiated but unheated control. As per our usual practice, patients received surgery and/or chemotherapy prior to radiotherapy. Radiation doses were 46-50 Gy followed by a boost of ≤16 Gy at 1.8-2 Gy per fraction. EHS and control sectors received the same dose. RESULTS: A total of 57 evaluable cases with average follow-up of 79 months experienced two local and two nodal recurrences. There was no significant difference in ≥grade 2 toxicity for heated versus control sectors (LR χ(2 )= 0.78, p = 0.38) with no relationship between number of hyperthermia sessions and toxicity (LR χ(2 )= 2.90, p = 0.09). CONCLUSIONS: Simultaneous full-dose thermoradiotherapy for breast cancer is feasible and well tolerated, with no significant difference in late toxicity between electively heated and unheated control sectors. All patients had hyperthermia to the primary tumour site with excellent local control.
Authors: C C Vernon; J W Hand; S B Field; D Machin; J B Whaley; J van der Zee; W L van Putten; G C van Rhoon; J D van Dijk; D González González; F F Liu; P Goodman; M Sherar Journal: Int J Radiat Oncol Biol Phys Date: 1996-07-01 Impact factor: 7.038
Authors: R J Myerson; W L Straube; E G Moros; B N Emami; H K Lee; C A Perez; M E Taylor Journal: Int J Hyperthermia Date: 1999 Jul-Aug Impact factor: 3.914
Authors: Sabine Oldenborg; Rob M Van Os; Caroline M Van rij; Johannes Crezee; Jeroen B Van de Kamer; Emiel J T Rutgers; Elisabeth D Geijsen; Paul J Zum vörde sive vörding; Caro C E Koning; Geertjan Van tienhoven Journal: Int J Hyperthermia Date: 2010 Impact factor: 3.914
Authors: R J Myerson; B N Emami; C A Perez; W Straube; L Leybovich; D Von Gerichten Journal: Int J Hyperthermia Date: 1992 Jan-Feb Impact factor: 3.914
Authors: Tamer Refaat; Sean Sachdev; Vythialinga Sathiaseelan; Irene Helenowski; Salah Abdelmoneim; Margaret C Pierce; Gayle Woloschak; William Small; Bharat Mittal; Krystyna D Kiel Journal: Breast Date: 2015-04-18 Impact factor: 4.380
Authors: Lifei Zhu; Michael B Altman; Andrei Laszlo; William Straube; Imran Zoberi; Dennis E Hallahan; Hong Chen Journal: Ultrasound Med Biol Date: 2019-02-14 Impact factor: 2.998
Authors: David S Hersh; Anthony J Kim; Jeffrey A Winkles; Howard M Eisenberg; Graeme F Woodworth; Victor Frenkel Journal: Neurosurgery Date: 2016-11 Impact factor: 4.654
Authors: Bridget M Crawford; Ronnie L Shammas; Andrew M Fales; David A Brown; Scott T Hollenbeck; Tuan Vo-Dinh; Gayathri R Devi Journal: Int J Nanomedicine Date: 2017-08-26