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.
Department of Radiation Oncology, Hyperthermia Unit, Erasmus MC-Daniel den Hoed Cancer Center, 3008, Rotterdam, The Netherlands. firstname.lastname@example.org
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).
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.
The present study shows that reRT + HT treatment–either alone or combined with surgery–improves LC rates in patients with RAS.