Strahlenther Onkol. 2013 May;189(5):387-93. doi: 10.1007/s00066-013-0316-3. Epub 2013 Apr 4.

Linthorst M, van Geel AN, Baartman EA, Oei SB, Ghidey W, van Rhoon GC, van der Zee J.

Source

Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC-Daniel den Hoed Cancer Center, 3008, Rotterdam, The Netherlands. m.linthorst@erasmusmc.nl

Abstract

PURPOSE:

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.

PATIENTS AND 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.

CONCLUSION:

The present study shows that reRT + HT treatment–either alone or combined with surgery–improves LC rates in patients with RAS.