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Erschienen in: Strahlentherapie und Onkologie 4/2024

Open Access 10.11.2023 | Original Article

Radiation therapy of breast cancer in the Nahe Breast Center: first results of an analysis in the context of health services research

verfasst von: PD Dr. Ralph Mücke, MD, PhD, Gabor Heim, MD, Robert Gosenheimer, MD, Volker Schmitz, MD, PhD, Christoph Schulz, MD, Per Knoeß, MD, Khashayar Fakhrian, MD, PhD, Christina Harvey, Christiane Mücke, Gabriele Lochhas, MD, Ute Metzmann, MD, Matthias Bussmann, MD, Markus Paschold, MD, PhD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 4/2024

Abstract

Background

The first evaluation of radiotherapy results in patients with breast cancer treated as part of a multimodal oncologic therapy in the Nahe Breast Center is presented. Analysis of the results was performed using an in-practice registry.

Patients and methods

From September 2016 to December 2017, 138 patients (median age 62.5 years; range 36–94 years) with breast cancer (right side, n = 67; left side, n = 71) received adjuvant radiation therapy. Of these, 103 patients received gyneco-oncologic care at the Nahe Breast Center, and 35 were referred from outside breast centers. The distribution into stages was as follows: stage I, n = 48; stage II, n = 68; stage III, n = 19; stage IV, n = 3. Neoadjuvant chemotherapy was given to 19 and adjuvant chemotherapy to 50 patients. Endocrine treatment was given to 120 patients. Both 3D conformal (n = 103) and intensity-modulated (n = 35) radiotherapy were performed with a modern linear accelerator.

Results

With a median follow-up of 60 months (1–67), local recurrence occurred in 4/138 (2.9%) and distant metastasis in 8/138 (5.8%) patients; 7/138 (5.1%) patients died of their tumors during the follow-up period. The actuarial 5‑year local recurrence-free survival of all patients was 97.1%, and the actuarial 5‑year overall survival of all patients was 94.9%. We observed no grade 3 or 4 radiogenic side effects.

Conclusion

The results of radiotherapy for breast carcinoma at the Nahe Breast Center are comparable to published national and international results. In particular, the local recurrence rates in our study, determined absolutely and actuarially, are excellent, and demonstrate the usefulness of radiotherapy.

Introduction

This study is an initial evaluation of adjuvant radiation as part of the multimodal therapy of patients with breast cancer treated at the Nahe Breast Center in Bad Kreuznach. The study was performed to evaluate the quality of the treatment internally and to compare it with the results of national and international studies. The analysis is considered very important in identifying any deviations so they can be corrected if necessary. Data were collected using an internal practice registry in radiotherapy, which was kept in a disciplined manner over the years for all patients. Parameters such as type of surgery and systemic therapy were included. To ensure a sufficient follow-up period, only patients who received radiation from September 2016 to the end of 2017 were included in the analysis.

Patients and methods

From September 2016 to December 2017, 138 patients (median age 62.5 years; range 36–94 years) with breast cancer (right side, n = 67; left side, n = 71) received adjuvant radiation therapy. Of these, 103 patients received gyneco-oncologic care at the Nahe Breast Center, and 35 were referred from outside breast centers. The distribution into stages was as follows: stage I, n = 48; stage II, n = 68; stage III, n = 19; stage IV, n = 3. Neoadjuvant chemotherapy was given to 19 and adjuvant chemotherapy to 50 patients. Endocrine treatment was given to 120 patients.
Radiation therapy was performed with a modern linear accelerator from Elekta (Stockholm, Sweden). All modern radiation techniques such as 3D conformal radiation (n = 103) and intensity-modulated radiation (IMRT; n = 35) were used. Radiation therapy target volumes and total doses were determined in each case according to the national S3 guideline, with each individual case discussed in an interdisciplinary tumor conference prior to the start of radiation. The median total radiation dose after breast-conserving surgery (n = 107) was 62 Gy (50–66), and after mastectomy (n = 31) it was 50 Gy (40–60).
The distribution of patient and radiation criteria is given in Tables 1 and 2.
Table 1
Patient data
T‑stage
T0
1/138
(0.7%)
T1
75/138
(54.4%)
T2
45/138
(32.6%)
T3
13/138
(9.4%)
T4
4/138
(2.9%)
N‑stage
N0
91/138
(65.9%)
N1
31/138
(22.5%)
N2
12/138
(8.7%)
N3
4/138
(2.9%)
Grading
G1
24/138
(17.4%)
G2
79/138
(57.2%)
G3
35/138
(25.4%)
Receptor status
ER+/PR+
120/138
(87.0%)
ER−/PR−
18/138
(13.0%)
HER-2/neu status
Negative
126/138
(91.4%)
Positive
12/138
(8.6%)
Lymph node surgery
Sentinel Node
98/138
(71.0%)
Axilla-Dissection
40/138
(29.0%)
Surgery
Breast Conserving
107/138
(77.5%)
Ablatio
31/138
(22.5%)
Resection status
R0
138/138
(100.0%)
T-stage tumor size, N-stage lymph node involvement, HER-2/neu status human epidermal growth factor receptor type 2
Table 2
Radiation data
Fractionation
Hypofractionated
4/138
(2.9%)
Normofractionated
134/138
(97.1%)
RT technique
3D
103/138
(74.6%)
IMRT
35/138
(26.4%)
Boost
Simultaneous
85/138
(61.6%)
Sequential
17/138
(12.3%)
No Boost
36/138
(26.1%)
RT of lymph nodes
Yes
48/138
(34.8%)
No
90/138
(65.2%)
IMRT intensity-modulated radiation therapy, 3D three-dimensional conformal radiation therapy, RT radiation therapy

Statistics

All data were stored and analyzed using the SPSS statistical package 29.0 (IBM. Corp., Armonk, NY, USA). Descriptive statistics were computed for continuous and categorical variables. The statistics computed included median and interquartile ranges of ordinal variables, means and standard deviations of continuous variables, and frequencies and relative frequencies of categorical factors. The period to death or recurrence or last follow-up was estimated with the Kaplan–Meier method. Differences between curves were assessed by the Mantel log-rank test for censored survival data. All p-values were from two-sided statistical tests, and values of p < 0.05 were considered statistically significant.

Results

With a median follow-up of 60 months (1–67), local recurrence occurred in 4/138 (2.9%) and distant metastasis in 8/138 (5.8%) patients; 7/138 (5.1%) patients died of their tumors during the follow-up period.

Local recurrence-free survival

The actuarial 5‑year local recurrence-free survival of all patients was 97.1% (Fig. 1).

Overall survival

The actuarial 5‑year overall survival of all patients was 94.9% (Fig. 2). Further calculated survival data are shown in Tables 3 and 4.
Table 3
Local recurrence-free survival data depending on endocrine therapy, chemotherapy, and grading
With endocrine therapy
n = 120
1 event, 119 censored cases
99.2% (95% CI: 97.8–100.6)
p < 0.001
Without endocrine therapy
n = 18
3 events, 15 censored cases
83.3% (95% CI: 69.8–96.8)
Without chemotherapy
n = 69
0 events, 69 censored cases
100.0%a
p < 0.001
With adjuvant chemotherapy
n = 50
1 event, 49 censored cases
98.0% (95% CI: 94.7–101.3)
With neoadjuvant chemotherapy
n = 19
3 events, 16 censored cases
84.2% (95% CI: 69.5–98.9)
Grade 1
n = 24
0 events, 24 censored cases
100.0%a
p < 0.001
Grade 2
n = 79
0 events, 79 censored cases
100.0%a
Grade 3
n = 35
4 events, 31 censored cases
88.6% (95% CI: 77.7–98.6)
CI confidence intervals
aNo CI are calculated because all cases are censored
Table 4
Overall survival data depending on endocrine therapy, chemotherapy, and grading
With endocrine therapy
n = 120
5 events, 115 censored cases
95.8% (95% CI: 92.8–98.8)
p = 0.201
Without endocrine therapy
n = 18
2 events, 16 censored cases
88.9% (95% CI: 77.7–100)
Without chemotherapy
n = 69
0 events, 69 censored cases
100.0%a
p = 0.019
With adjuvant chemotherapy
n = 50
5 events, 45 censored cases
90.0% (95% CI: 84.2–95.8)
With neoadjuvant chemotherapy
n = 19
2 events, 17 censored cases
89.5% (95% CI: 73.1–105.9)
Grade 1
n = 24
0 events, 24 censored cases
100.0%a
p < 0.039
Grade 2
n = 79
3 events, 76 censored cases
96.2% (95% CI: 93.0–99.4)
Grade 3
n = 35
4 events, 31 censored cases
88.6% (95% CI: 78.1–99.1)
CI confidence intervals
aNo CI are calculated because all cases are censored
Toxicity data are shown in Tables 5 and 6.
Table 5
Toxicity data at the end of radiotherapy
Radiation dermatitis
Grade 0
24/138
(17.4%)
Grade 1
100/138
(72.5%)
Grade 2
14/138
(10.1%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Breast pain
Grade 0
125/138
(90.6%)
Grade 1
9/138
(6.5%)
Grade 2
4/138
(2.9%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Fatigue
Grade 0
59/138
(42.7%)
Grade 1
71/138
(51.5%)
Grade 2
8/138
(5.8%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Pneumonitis
Grade 0
135/138
(97.8%)
Grade 1
3/138
(2.2%)
Grade 2
0/138
(0%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Table 6
Toxicity data during follow-up
Fibrosis
Grade 0
113/138
(81.9%)
Grade 1
21/138
(15.2%)
Grade 2
4/138
(2.9%)
Grade 3
0/116
(0%)
Grade 4
0/116
(0%)
Hyperpigmentation
Grade 0
98/138
(71.0%)
Grade 1
34/138
(24.6%)
Grade 2
6/138
(4.4%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Lymphedema breast
Grade 0
120/138
(87.0%)
Grade 1
12/138
(8.7%)
Grade 2
6/138
(4.3%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Lymphedema arm
Grade 0
128/138
(92.7%)
Grade 1
7/138
(5.1%)
Grade 2
3/138
(2.2%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)
Lung fibrosis
Grade 0
135/138
(97.8%)
Grade 1
3/138
(2.2%)
Grade 2
0/138
(0%)
Grade 3
0/138
(0%)
Grade 4
0/138
(0%)

Discussion

Our results of breast cancer irradiation in the context of multimodal therapy are in line with nationally and internationally published results. In particular, the 5‑year local recurrence rate for all patients in our study, determined absolutely (2.9%) and actuarially (97.1%), is excellent and demonstrates the usefulness of radiotherapy. It also shows the high professional and technical quality of all employees in our practice. The results confirm that postoperative radiation is the most important and effective measure to reduce the risk of local recurrence [112]. If we follow the current literature, this finding applies to all breast cancer subgroups. Thus, all women should be presented for radio-oncology after breast-conserving surgery, and predictive markers for decision-making cannot be relied on.
The currently published PRIME II trial also demonstrates these excellent local effects of radiation, although the authors recommend against radiation for women older than 65 years with hormone receptor positivity after breast-conserving surgery if they consistently take antiestrogenic medication for 5 years. In this study, the local recurrence rate of this group of patients after 10 years without radiation was 8.6%, and with radiation it was 1% [13].
Meta-analyses have even shown that local irradiation not only reduces the local recurrence rate but also reduces the rate of distant recurrences [1, 2].
With the use of state-of-the-art irradiation techniques, as we apply them in our center, both pronounced acute and late radiogenic side effects are very rare: no grade 3 and 4 toxicities occurred in our evaluation, and the pneumonitis rate is only 2.2% (Table 5).
Skin toxicity is comparable to currently published data. Pulmonary toxicity is slightly better, but only grade 1 symptomatic pneumonitis was reported in our study. Asymptomatic pneumonitis was not analyzed [14, 15].
A limitation of this study is the still very small number of patients, especially in the subgroups. We are very aware that this analysis is not a prospective randomized trial. The worse outcomes of patients with chemotherapy and with histological grade 3 disease indicate that these groups included patients with more risk factors. For example, only 4/24 patients (16.6%) with a grading of 1 but 33/35 patients (94.3%) with a grading of 3 received chemotherapy. Regarding nodal status, there were 31/91 patients (34.1%) with negative nodal status and 38/47 patients (80.9%) with positive nodal status who received chemotherapy. We will not further discuss the presented subgroups, such as those who did not receive endocrine treatment and did receive chemotherapy and patients with different grades of disease, but we wanted to show them. Nevertheless, we wanted to check the quality of our work for the first time after a follow-up of 5 years.
The results indicate high professional quality in the treatment of breast cancer at the Nahe Breast Center. Through regular training and quality improvement measures, everything is being done to maintain or even improve this high level of quality.

Conclusion

The results of radiotherapy for breast cancer at the Nahe Breast Center are comparable to published national and international results. In particular, the local recurrence rates in our study, determined absolutely and actuarially, are excellent and demonstrate the usefulness of radiotherapy.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Conflict of interest

R. Mücke, G. Heim, R. Gosenheimer, V. Schmitz, C. Schulz, P. Knoeß, K. Fakhrian, C. Harvey, C. Mücke, G. Lochhas, U. Metzmann, M. Bussmann, and M. Paschold declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Strahlentherapie und Onkologie

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•Kommentierte Literatur aus der Radioonkologie, Strahlenbiologie und -physik

Literatur
1.
Zurück zum Zitat Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, Godwin J, Gray R, Hicks C, James S, MacKinnon E, McGale P, McHugh T, Peto R, Taylor C, Wang Y, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106CrossRefPubMed Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, Godwin J, Gray R, Hicks C, James S, MacKinnon E, McGale P, McHugh T, Peto R, Taylor C, Wang Y, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106CrossRefPubMed
2.
Zurück zum Zitat Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, Godwin J, Gray R, Pierce L, Whelan T, Wang Y, Peto R, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378(9804):1707–1716CrossRefPubMed Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, Godwin J, Gray R, Pierce L, Whelan T, Wang Y, Peto R, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378(9804):1707–1716CrossRefPubMed
3.
Zurück zum Zitat Pötter R, Gnant M, Kwasny W, Tausch C, Handl-Zeller L, Pakisch B, Taucher S, Hammer J, Luschin-Ebengreuth G, Schmid M, Sedlmayer F, Stierer M, Reiner G, Kapp K, Hofbauer F, Rottenfusser A, Pöstlberger S, Haider K, Draxler W, Jakesz R, Austrian Breast and Colorectal Cancer Study Group (2007) Lumpectomy plus tamoxifen or anastrozole with or without whole breast irradiation in women with favorable early breast cancer. Int J Radiat Oncol Biol Phys 68(2):334–340CrossRefPubMed Pötter R, Gnant M, Kwasny W, Tausch C, Handl-Zeller L, Pakisch B, Taucher S, Hammer J, Luschin-Ebengreuth G, Schmid M, Sedlmayer F, Stierer M, Reiner G, Kapp K, Hofbauer F, Rottenfusser A, Pöstlberger S, Haider K, Draxler W, Jakesz R, Austrian Breast and Colorectal Cancer Study Group (2007) Lumpectomy plus tamoxifen or anastrozole with or without whole breast irradiation in women with favorable early breast cancer. Int J Radiat Oncol Biol Phys 68(2):334–340CrossRefPubMed
4.
Zurück zum Zitat Hughes KS, Schnaper LA, Bellon JR, Cirrincione CT, Berry DA, McCormick B, Muss HB, Smith BL, Hudis CA, Winer EP, Wood WC (2013) Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol 31(19):2382–2387CrossRefPubMedPubMedCentral Hughes KS, Schnaper LA, Bellon JR, Cirrincione CT, Berry DA, McCormick B, Muss HB, Smith BL, Hudis CA, Winer EP, Wood WC (2013) Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol 31(19):2382–2387CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM, PRIME II investigators (2015) Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol 16(3):266–273CrossRefPubMed Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM, PRIME II investigators (2015) Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol 16(3):266–273CrossRefPubMed
6.
Zurück zum Zitat Blamey RW, Bates T, Chetty U, Duffy SW, Ellis IO, George D, Mallon E, Mitchell MJ, Monypenny I, Morgan DA, Macmillan RD, Patnick J, Pinder SE (2013) Radiotherapy or tamoxifen after conserving surgery for breast cancers of excellent prognosis: British Association of Surgical Oncology (BASO) II trial. Eur J Cancer 49(10):2294–2302CrossRefPubMed Blamey RW, Bates T, Chetty U, Duffy SW, Ellis IO, George D, Mallon E, Mitchell MJ, Monypenny I, Morgan DA, Macmillan RD, Patnick J, Pinder SE (2013) Radiotherapy or tamoxifen after conserving surgery for breast cancers of excellent prognosis: British Association of Surgical Oncology (BASO) II trial. Eur J Cancer 49(10):2294–2302CrossRefPubMed
7.
Zurück zum Zitat Fyles AW, McCready DR, Manchul LA, Trudeau ME, Merante P, Pintilie M, Weir LM, Olivotto IA (2004) Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 351(10):963–970CrossRefPubMed Fyles AW, McCready DR, Manchul LA, Trudeau ME, Merante P, Pintilie M, Weir LM, Olivotto IA (2004) Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 351(10):963–970CrossRefPubMed
8.
Zurück zum Zitat Kauer-Dorner D, Pötter R, Resch A, Handl-Zeller L, Kirchheiner K, Meyer-Schell K, Dörr W (2012) Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: alternative to mastectomy? Results from a prospective trial. Radiother Oncol 102(1):96–101CrossRefPubMed Kauer-Dorner D, Pötter R, Resch A, Handl-Zeller L, Kirchheiner K, Meyer-Schell K, Dörr W (2012) Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: alternative to mastectomy? Results from a prospective trial. Radiother Oncol 102(1):96–101CrossRefPubMed
9.
Zurück zum Zitat Sedlmayer F, Sautter-Bihl ML, Budach W, Dunst J, Fastner G, Feyer P, Fietkau R, Haase W, Harms W, Souchon R, Wenz F, Sauer R, Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) (2013) DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 189(10):825–833CrossRefPubMedPubMedCentral Sedlmayer F, Sautter-Bihl ML, Budach W, Dunst J, Fastner G, Feyer P, Fietkau R, Haase W, Harms W, Souchon R, Wenz F, Sauer R, Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) (2013) DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 189(10):825–833CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Wei J, Jiang Y, Shao Z (2020) The survival benefit of postmastectomy radiotherapy for breast cancer patients with T1-2N1 disease according to molecular subtype. Breast 51:40–49CrossRefPubMedPubMedCentral Wei J, Jiang Y, Shao Z (2020) The survival benefit of postmastectomy radiotherapy for breast cancer patients with T1-2N1 disease according to molecular subtype. Breast 51:40–49CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Guo X‑Y, Sun G‑Y, Wang H‑M, Liu M, Zhang Y‑J, Zhang N, Tang Y, Zhao X‑R, Jing H, Fang H, Wen G, Qi-Shuai G, Wu H‑F, Wang X‑H, Ma C‑Y, Li Y‑X, Cheng J, Shi MS-LW (2022) Effect of postmastectomy radiotherapy on pT1-2N1 breast cancer patients with different molecular subtypes. Breast 61:108–117CrossRefPubMed Guo X‑Y, Sun G‑Y, Wang H‑M, Liu M, Zhang Y‑J, Zhang N, Tang Y, Zhao X‑R, Jing H, Fang H, Wen G, Qi-Shuai G, Wu H‑F, Wang X‑H, Ma C‑Y, Li Y‑X, Cheng J, Shi MS-LW (2022) Effect of postmastectomy radiotherapy on pT1-2N1 breast cancer patients with different molecular subtypes. Breast 61:108–117CrossRefPubMed
12.
Zurück zum Zitat Ursini LA, Nuzzo M, Rosa C, Borgia M, Caravatta L, Di Tommaso M, Trignani M, Di Guglielmo FC, Ausili Cefaro G, Angelucci D, Muzi M, Martino G, Cianchetti E, Grossi S, Tavoletta S, Brocco D, Grassadonia A, Tinari N, Gildetti S, D’Ostilio N, Stuppia L, Porreca A, Di Nicola M, Genovesi D (2022) Whole breast radiotherapy in cN0 early breast cancer patients with pathological sentinel lymph nodes (pN1mic, pN1a) without axillary dissection: preliminary results of the observational LISEN trial. Strahlenther Onkol 198(7):612–621CrossRefPubMedPubMedCentral Ursini LA, Nuzzo M, Rosa C, Borgia M, Caravatta L, Di Tommaso M, Trignani M, Di Guglielmo FC, Ausili Cefaro G, Angelucci D, Muzi M, Martino G, Cianchetti E, Grossi S, Tavoletta S, Brocco D, Grassadonia A, Tinari N, Gildetti S, D’Ostilio N, Stuppia L, Porreca A, Di Nicola M, Genovesi D (2022) Whole breast radiotherapy in cN0 early breast cancer patients with pathological sentinel lymph nodes (pN1mic, pN1a) without axillary dissection: preliminary results of the observational LISEN trial. Strahlenther Onkol 198(7):612–621CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM (2023) Breast-conserving surgery with or without irradiation in early breast cancer. N Engl J Med 388:585–594CrossRefPubMed Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM (2023) Breast-conserving surgery with or without irradiation in early breast cancer. N Engl J Med 388:585–594CrossRefPubMed
14.
Zurück zum Zitat Amor BR, Bohli M, Naimi Z, Aissaoui D, Mejri N, Yahyaoui J, Hamdoun A, Kochbati L (2023) Hypofractionated radiotherapy after breast-conserving surgery: Clinical and dosimetric factors predictive of acute skin toxicity. Strahlenther Onkol 199(1):48–54CrossRefPubMed Amor BR, Bohli M, Naimi Z, Aissaoui D, Mejri N, Yahyaoui J, Hamdoun A, Kochbati L (2023) Hypofractionated radiotherapy after breast-conserving surgery: Clinical and dosimetric factors predictive of acute skin toxicity. Strahlenther Onkol 199(1):48–54CrossRefPubMed
15.
Zurück zum Zitat Mangesius J, Minasch D, Fink K, Nevinny-Stickel M, Lukas P, Ganswindt U, Seppi T (2023) Systematic risk analysis of radiation pneumonitis in breast cancer: role of cotreatment with chemo-, endocrine, and targeted therapy. Strahlenther Onkol 199(1):67–77CrossRefPubMed Mangesius J, Minasch D, Fink K, Nevinny-Stickel M, Lukas P, Ganswindt U, Seppi T (2023) Systematic risk analysis of radiation pneumonitis in breast cancer: role of cotreatment with chemo-, endocrine, and targeted therapy. Strahlenther Onkol 199(1):67–77CrossRefPubMed
Metadaten
Titel
Radiation therapy of breast cancer in the Nahe Breast Center: first results of an analysis in the context of health services research
verfasst von
PD Dr. Ralph Mücke, MD, PhD
Gabor Heim, MD
Robert Gosenheimer, MD
Volker Schmitz, MD, PhD
Christoph Schulz, MD
Per Knoeß, MD
Khashayar Fakhrian, MD, PhD
Christina Harvey
Christiane Mücke
Gabriele Lochhas, MD
Ute Metzmann, MD
Matthias Bussmann, MD
Markus Paschold, MD, PhD
Publikationsdatum
10.11.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 4/2024
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-023-02157-8

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