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01.05.2013 | Original article

Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall

verfasst von: M. Linthorst, MD., A.N. van Geel, M.D., Ph.D, E.A. Baartman, M.D., S.B. Oei, M.D., W. Ghidey, Ph.D., G.C. van Rhoon, Ph.D., J. van der Zee, M.D., Ph.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2013

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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.

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Titel: Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall
verfasst von: M. Linthorst, MD.
A.N. van Geel, M.D., Ph.D
E.A. Baartman, M.D.
S.B. Oei, M.D.
W. Ghidey, Ph.D.
G.C. van Rhoon, Ph.D.
J. van der Zee, M.D., Ph.D.
Publikationsdatum: 01.05.2013
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-013-0316-3

Springer Medizin

Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall