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Abramson Cancer CenterNCI CANCERLIT® Search: Radiotherapy for Breast Cancer - May 2002
National Cancer Institute®
Last Modified: May 1, 2002
Table of Contents
1
UI - 11764653
AU - Wratten C; Kilmurray J; Wright S; O'Brien P; Back M; Hamilton C; Denham
TI -
J
A study of high frequency ultrasound to assess cutaneous oedema in
conservatively managed breast.
SO - Front Radiat Ther Oncol 2002;37():121-7
AD - Department of Radiation Oncology, Mater Misericordiae Hospital,
Newcastle, Australia. mdcwr@alinga.newcastle.edu.au
2
UI - 11313882
AU - Bowers G; Reardon D; Hewitt T; Dent P; Mikkelsen RB; Valerie K;
TI -
Lammering G; Amir C; Schmidt-Ullrich RK
The relative role of ErbB1-4 receptor tyrosine kinases in radiation
signal transduction responses of human carcinoma cells.
SO - Oncogene 2001 Mar 15;20(11):1388-97
AD - Department of Radiation Oncology, Medical College of Virginia Campus,
Virginia Commonwealth University, Richmond, Virginia, VA23298-0058, USA.
Activation of the epidermal growth receptor (ErbB1) occurs within
minutes of a radiation exposure. Immediate downstream consequences of
this activation are currently indistinguishable from those obtained with
growth factors (GF), e.g. stimulation of the pro-proliferative
mitogen-activated protein kinase (MAPK). To identify potential
differences, the effects of GFs and radiation on other members of the
ErbB family have been compared in mammary carcinoma cell lines differing
in their ErbB expression profiles. Treatment of cells with EGF
(ErbB1-specific) or heregulin (ErbB4-specific) resulted in a hierarchic
transactivations of ErbB2 and ErbB3 dependent on GF binding specificity.
In contrast, radiation indiscriminately activated all ErbB species with
the activation profile reflecting that cell's ErbB expression profile.
Downstream consequences of these ErbB interactions were examined with
MAPK after specifically inhibiting ErbB1 (or 4) with tyrphostin AG1478
or ErbB2 with tyrphostin AG825. MAPK activation by GFs or radiation was
completely inhibited by AG1478 indicating total dependance on ErbB1 (or
4) depending on which ErbB is expressed. Inhibiting ErbB2 caused an
enhanced MAPK response simulating an amplified ErbB1 (or 4) response.
Thus ErbB2 is a modulator of ErbB1 (or 4) function leading to different
MAPK response profiles to GF or radiation exposure.
3
UI - 11955729
AU - Legal JD; De Crevoisier R; Lartigau E; Morsli K; Dossou J; Chavaudra N;
TI -
Sanfilippo N; Bourhis J; Eschwege F; Parmentier C
Chromosomal aberrations induced by chemotherapy and radiotherapy in
lymphocytes from patients with breast carcinoma.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1186-95
AD - UPRES EA29-10, Institut Gustave-Roussy, Villejuif, France.
PURPOSE: Stable chromosomal aberrations (SCAs) have been found in
circulating lymphocytes from patients treated for breast carcinoma.
Therefore, we tried to define their incidence in such patients, to
determine an in vitro dose-effect relationship, and to correlate these
data with clinical parameters. METHODS AND MATERIALS: This prospective
study included 25 patients who, after surgery, underwent either
radiotherapy (RT) alone (n = 15) or RT combined with chemotherapy (n =
10). SCAs were scored using the fluorescent in situ hybridization
technique before RT and 4 and 12 months after RT. Dose-effect curves
were established by in vitro irradiation of blood samples with 2 and 4
Gy, before and after treatment. RESULTS: In all patients, the rate of
SCAs increased significantly after external irradiation. No significant
decrease in SCAs was observed during the first year after RT. RT and
chemotherapy had no effect on the lymphocyte in vitro dose-effect
relationship. No relationship was found in the distribution of patients
between the yield of SCAs scored after external irradiation and after in
vitro irradiation. SCAs after RT or in vitro irradiation did not
correlate with family history of breast carcinoma or acute toxicity of
treatment. More significantly, the yield of SCA after external
irradiation was strongly related to the irradiation of the internal
mammary chain and the supraclavicular lymph node area, suggesting that
the volume of irradiated blood vessels was an essential parameter in
determining the rate of SCAs. CONCLUSION: A high and stable yield of
SCAs persisted at least 1 year after external irradiation. The nature of
the volume irradiated containing large blood vessels was the major
determinant of the observed biologic dose.
4
UI - 11955730
AU - Wennberg B; Gagliardi G; Sundbom L; Svane G; Lind P
TI -
Early response of lung in breast cancer irradiation: radiologic density
changes measured by CT and symptomatic radiation pneumonitis.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1196-206
AD - Department of Medical Physics, Huddinge University Hospital, Stockholm,
Sweden. berit@asf.hs.sll.se
PURPOSE: To quantify radiologic changes in the lung with CT after
radiotherapy (RT) for breast cancer (BC) and to study their association
with treatment techniques and symptomatic radiation pneumonitis (RP).
METHODS AND MATERIALS: CT scans of the lungs were performed before and 4
months after RT in 121 BC patients treated with four different RT
techniques. The changes in mean density (MDCs) were analyzed at two lung
levels (i.e., the central and apical CT slice). The central CT slice was
also analyzed with respect to the MDCs in the anterior third and
anterior half of the ipsilateral lung area. In mastectomized patients
who received chest wall RT with an en-face electron beam, the maximal
depths for a range of isodose curves were measured. The occurrence of
mild/moderate symptomatic RP was assessed prospectively 1, 4, and 7
months after RT. Data on covariates with potential confounding effect on
RT-induced lung toxicity were also collected prospectively. RESULTS: In
the entire study population, an association between the MDCs in the
anterior third of the central CT slice and treatment technique (p
<0.001) and symptomatic RP (p <0.001) was found. Among patients with
chest wall treatment consisting of an en-face electron beam, the MDCs of
the anterior third of the central CT slice correlated with the 35%
isodose curve (16-30 Gy) (p = 0.046) and age (p <0.001). No association
between post-RT lung density changes and pre-RT chemotherapy, concurrent
tamoxifen intake, or smoking habits was found. Among patients treated
with locoregional RT, an association was found between the MDCs in the
anterior third of the central CT slice and the incidence of RP. MDCs in
the apical CT slice, however, were not associated with RP. CONCLUSION:
The results imply that short-term post-RT lung density changes and
symptomatic RP were associated with RT techniques, total doses as low as
16-30 Gy, and increasing age. Structural changes in the central part of
lung appeared to be more important for the development of RP than
changes in the apex.
5
UI - 11955731
AU - Johansson S; Svensson H; Denekamp J
TI -
Dose response and latency for radiation-induced fibrosis, edema, and
neuropathy in breast cancer patients.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1207-19
AD - Department of Radiation Sciences, Translational Research Group, Umea
University Hospital, Sweden. silvia.johansson@onkologi.umu.se
PURPOSE: To study the incidence of various forms of late normal tissue
injuries to determine the latency and dose-response relationships.
METHODS: We retrospectively analyzed the clinical records of 150 breast
cancer patients treated with radiotherapy after mastectomy in the mid to
late 1960s. None of the patients had received chemotherapy as a part of
their primary treatment. Radiotherapy was delivered to the parasternal,
axillary, and supraclavicular lymph node regions. Almost all the
patients continued to be checked at regular 3-month to 1-year intervals
at our Oncology Department. Detailed records were available for the
entire 34 years of the follow-up period. The patients were divided into
3 groups. The prescribed dose was either 11 x 4 Gy (treated with 60Co
photons) or 11 x 4 Gy or 14-15 x 3 Gy (treated with both 60Co photons
and electrons). The dose recalculation at the brachial plexus where the
axillary and supraclavicular beams overlapped was performed in the early
1970s and expressed in cumulative radiation effect (CRE) units. It
varied widely among the individual patients. The received dose has now
been converted to biologic effective dose(3) units, and from that into
the equivalent dose in 2-Gy fractions to plot the dose-response
relationships. RESULTS: We present a comparison of the latency and
frequency of fibrosis, edema, brachial plexus neuropathy, and paralysis
in the three different subgroups and the total group. Dose-response
relationships are shown at 5, 10, and 30 years after irradiation.
CONCLUSION: The use of large daily fractions, combined with hotspots
from overlapping fields, was the cause of the complications. Clear
dose-response curves were seen for late radiation injuries. The
incidence seen at 5 years did not represent the full spectrum of
injuries. Doses that seem safe at 5 years can lead to serious
complications later.
6
UI - 11955732
AU - Pierce LJ; Butler JB; Martel MK; Normolle DP; Koelling T; Marsh RB;
TI -
Lichter AS; Fraass BA
Postmastectomy radiotherapy of the chest wall: dosimetric comparison of
common techniques.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1220-30
AD - Department of Radiation Oncology, University of Michigan School of
Medicine, Ann Arbor, MI 48109-0010, USA. ljpierce@umich.edu
PURPOSE: To compare seven techniques for irradiation of the
postmastectomy chest wall (CW) using normal tissue complication
probability (NTCP) predictions for pneumonitis and ischemic heart
disease and dose-volume histogram analyses for normal and target
tissues. METHODS AND MATERIALS: Plan comparisons were performed for 20
left-sided postmastectomy CW RT cases using target volumes based on
clinical delineation of standard field borders. Seven common treatment
techniques were planned for each case, using a prescription of 50 Gy in
25 fractions to the CW and internal mammary node (IMN) targets. NTCP
model metrics were used to quantify the risks of pneumonitis and
ischemic heart disease, supplemented by dose-volume metrics to assess
the target coverage to the CW and IMNs, as well as normal tissue dose
(lung and heart). RESULTS: Overlap in the distributions of the CW mean
dose for all plans was found, except cobalt, which was significantly
less than the remaining techniques (global F test, F = 21.90, p
<0.0001). Standard tangents produced a significantly lower IMN mean dose
than all other methods, as expected (F = 59.55, p < 0.0001); the reverse
hockey stick and cobalt techniques were lower than the other methods,
which were statistically similar. Cobalt produced a significantly higher
percentage of the heart that received >30 Gy (V30) than the other
methods (F = 49.76, p <0.0001). Use of partially wide tangent fields
(PWTFs) resulted in the smallest heart V30. Use of cobalt fields
resulted in a significantly greater NTCP estimate for ischemic heart
disease than all the remaining techniques (F = 70.39, p <0.0001).
Standard tangents resulted in a percentage of the lung receiving >20 Gy
(V20) significantly less than with PWTFs, 30/70 and 20/80
photon/electron mix, and reverse hockey stick techniques. NTCP estimates
for pneumonitis revealed significantly better results with standard
tangents (F = 6.57, p <0.0001). CONCLUSION: No one technique studied
combines the best CW and IMN coverage with minimal lung and heart
complication probabilities. The choice of technique should be based on
clinical discretion and the technical expertise available to implement
these complex plans. Of the seven techniques studied, this analysis
supports PWTFs as the most appropriate balance of target coverage and
normal tissue sparing when irradiating the CW and IMN.
7
UI - 11955733
AU - Yap J; Chuba PJ; Thomas R; Aref A; Lucas D; Severson RK; Hamre M
TI -
Sarcoma as a second malignancy after treatment for breast cancer.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1231-7
AD - Department of Radiation Oncology, Wayne State University School of
Medicine, Detroit, MI, USA.
BACKGROUND: Second malignant neoplasms may be a consequence of
radiotherapy for the treatment of breast cancer. Prior studies
evaluating sarcomas as second malignant neoplasms in breast cancer
patients have been limited by the numbers of patients and relatively low
incidence of sarcoma. Using data from the Surveillance, Epidemiology and
End Results registries, we evaluated the influence of radiation therapy
on the development of subsequent sarcomas in cases with primary breast
cancer. METHODS: Cases with primary invasive breast cancer (n = 274,572)
were identified in the Surveillance, Epidemiology and End Results Cancer
Incidence Public-Use Database (1973-1997). The database was then queried
to determine the cases developing subsequent sarcomas (n = 263).
Eighty-seven of these cases received radiation therapy, and 176 had no
radiation therapy. The cumulative incidence of developing secondary
sarcoma and the survival post developing secondary sarcoma were
determined by the Kaplan-Meier method. RESULTS: The occurrence of
sarcoma was low, regardless of whether cases received or did not receive
radiation therapy: 3.2 per 1,000 (SE [standard error] = 0.4) and 2.3 per
1,000 (SE = 0.2) cumulative incidence at 15 years post diagnosis,
respectively (p = 0.001). Of the sarcomas occurring within the field of
radiation, angiosarcoma accounted for 56.8%, compared to only 5.7% of
angiosarcomas occurring in cases not receiving radiotherapy. The
cumulative incidence of angiosarcoma at 15 years post diagnosis was 0.9
per 1,000 for cases receiving radiation (SE = 0.2) and 0.1 per 1,000 for
cases not receiving radiation (SE < 0.1). Overall survival was poor for
cases of sarcoma after breast cancer (27-35% at 5 years), but not
significantly different between patients receiving or not receiving
radiation therapy for their primary breast cancer. CONCLUSIONS:
Radiotherapy in the treatment of breast cancer is associated with an
increased risk of subsequent sarcoma, but the magnitude of this risk is
small. Angiosarcoma is significantly more prevalent in cases treated
with radiotherapy, occurring especially in or adjacent to the radiation
field. The small difference in risk of subsequent sarcoma for breast
cancer patients receiving radiotherapy does not supersede the benefit of
radiotherapy.
8
UI - 11977387
AU - Sautter-Bihl ML; Hultenschmidt B; Melcher U; Ulmer HU
TI -
Radiotherapy of internal mammary lymph nodes in breast cancer. Principle
considerations on the basis of dosimetric data.
SO - Strahlenther Onkol 2002 Jan;178(1):18-24
AD - Department of Radiotherapy, Stadtisches Klinikum Karlsruhe, Germany.
strahlentherapie@klinikum-karlsruhe.de
BACKGROUND: Radiotherapy of internal mammary lymph nodes (IMN) in breast
cancer is discussed controversially due to its potential toxicity and
debatable efficacy. Aim of the present study was to assess the cardiac
and lung dose in 3-D planned radiotherapy and to discuss these results
with regard to arguments pro and contra IMN irradiation. PATIENTS AND
METHODS: 32 patients underwent 3-D planning (Helax TMS) for irradiation
of breast and IMN in three different techniques either using separate
IMN fields (A, B) or a wide tangent (C). For each technique the
respective doses to the heart (including the base of the aorta and the
ostium of the coronary arteries) and lung were analyzed in dose volume
histograms. RESULTS: The mean dose to the heart (left side irradiation)
was 6.4 Gy (A), 8.1 Gy (B) and 3.8 Gy (C). The mean dose to the lung was
11.7 Gy (A), 15.4 Gy (B) and 10.2 Gy (C). The 10-Gy isodose comprised
19.5% (A), 32.9% (B) and 5.6% (C) of the heart (left breast). The
respective values for the 20-Gy isodose were 7.8, 11.5 and 4.4%. The
irradiated volumes of the lung were 37.7% (A), 52.7% (B) and 20% (C) in
the 10-Gy isodose. The 20-Gy isodose comprised 16.7% (A), 28.3% (B) and
17.8% (C). CONCLUSION: Whether radiotherapy of the IMN may improve
treatment results in breast cancer is currently unresolved. However, the
present data indicate that relevant cardiovascular side effects are
unlikely to occur. Thus, the indication should be considered on the
basis of individual risk factors.
9
UI - 11906388
AU - Chua B; Ung O; Boyages J
TI -
Treatment of the axilla in early breast cancer: past, present and
future.
SO - ANZ J Surg 2001 Dec;71(12):729-36
AD - Department of Radiation Oncology, Westmead Hospital, New South Wales,
Australia.
BACKGROUND: The optimal treatment of the axilla in early breast cancer
is controversial. The present study reviews the pattern and predictors
of regional recurrence (RR) and prognosis after RR in patients with
early breast cancer treated by conservative surgery and radiotherapy (CS
+ RT). Implications of the results on current practice and future
directions are explored. METHODS: Between 1979 and 1994, 1158 patients
with stage I or II breast cancer were treated with CS + RT at Westmead
Hospital. Two groups of patients were compared: 782 patients who
underwent axillary dissection (axillary surgery group) and 229 patients
who received radiotherapy (axillary RT group) as the only axillary
treatment. At least 10 lymph nodes were dissected in 82% of the axillary
surgery group. Of the women in the RT group, 90% received RT to the
axilla and supraclavicular fossa (SCF) only and 10% also received RT to
the internal mammary chain (IMC). RESULTS: With a median follow-up
period of 79 months for the axillary surgery group and 111 months for
the axillary RT group, 27 patients developed a RR (2.8% and 2.2%,
respectively). Seven patients (0.9%) in the axillary surgery group and
three patients (1.3%) in the axillary RT group developed a RR in the
axilla (P, not significant). Of the patients with SCF recurrences, 14
(1.8%) were in the axillary surgery group and one (0.4%) in the axillary
RT group (P, not significant). One patient in the axillary surgery group
developed concurrent axillary and SCF recurrences, while a patient in
the axillary RT group developed an IMC recurrence. Twenty (74%) of the
27 patients with a RR developed a concurrent or subsequent distant
relapse (30% and 44%, respectively). In the pathologically node-positive
patients, the axillary recurrence rate was higher in those who had less
than five nodes removed (17%) than those who had 10 or more nodes
removed (0%; P = 0.01). The SCF recurrence rate was higher in patients
with four or more positive axillary nodes (9.5%) than in those with 0-3
positive nodes (1.5%; P = 0.003). CONCLUSION: Adequate treatment of the
axilla by surgery or RT alone is associated with a low rate of RR. The
incidence of distant relapse was substantial in patients who developed a
RR, which gives emphasis to the importance of optimizing local-regional
control.
10
UI - 11977644
AU - Wang S; Li Y; Yu Z
TI -
[Postmastectomy radiotherapy for early breast cancer]
SO - Zhonghua Zhong Liu Za Zhi 2002 Jan;24(1):68-70
AD - Department of Radiation Oncology, Cancer Institute (Hospital), Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing
100021, China.
OBJECTIVE: To investigate the value of postmastectomy radiotherapy for
early breast cancer. METHODS: From 1983 to 1991, 605 patients with
T1-2N0-1M0 breast cancer were treated by radical mastectomy in our
hospital. 149 patients underwent surgery alone(S group), and the
remaining 456 patients received further adjuvant treatment. Of these
patients, 135 received postoperative radiotherapy(S + R group), 113
adjuvant chemotherapy or tamoxifen(S + Y group), and 208 adjuvant
chemotherapy or tamoxifen plus radiotherapy(S + Y + R group). Here,
chemotherapy plus tomoxifen is designated as systematically therapy. The
locoregional recurrence (LRR), disease-free survival (DFS), and overall
survival (OS) rates were calculated by Kaplan-Meier analysis. The
differences in locoregional recurrence and survival between these groups
were compared by logrank test. RESULTS: The 10-year actuarial LRR, OS
and DFS rates for all patients were 13.4%, 81.6%, and 67.6%,
respectively. The 10-year LRR rate was 10.3% for patients with negative
axillary nodes, 9.4% for those with 1-3 positive nodes, and 25.9% for
those with four or more positive nodes. The locoregional recurrence was
significantly higher in patients with four or more positive nodes as
compared to those with negative or 1-3 positive nodes (P < 0.05). For
the S and S + R groups, the 10-year actuarial LRR rate was 18.7% in the
S group and 7.5% in the S + R group (P = 0.017), the corresponding OS
and DFS rates of these two groups were 82.1% and 81.1% (P = 0.618), and
65.2% and 71.6% (P = 0.457), respectively. For the S + Y and S + Y + R
groups, the 10-year actuarial LRR rate was 21.1% in the S + Y group and
9.5% in the S + Y + R group (P = 0.001), There, the corresponding OS and
DFS rates were 75.5% and 85.0% (P = 0.020), and 59.3% and 70.2% (P =
0.003), respectively. Only for patients with four or more positive nodes
who had had systematic therapy, radiotherapy was beneficial; the 10-year
actuarial LRR of patients who received systematic therapy only was 40.1%
as compared with 15.1% of those who received systematic therapy plus
radiotherapy; Their OS rates were 55.4% and 67.1% (P = 0.040) and their
DFS rates were 30.5% and 57.3% (P = 0.001). CONCLUSION: Post-mastectomy
radiotherapy is able to significantly decrease the locoregional
recurrence and improve the survival of patients with four or more
positive axillary nodes. We suggest that postmastectomy radiotherapy be
given as routine for these patients.
11
UI - 11989940
AU - Olmi P
TI -
Limits to the radiation therapy due to age.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S95-7
AD - Divisione di Radioterapia, Istituto Nazionale Tumori, Milano.
12
UI - 11769959
AU - McNeese MD
TI -
Post-mastectomy irradiation: the continuing controversy.
SO - Biomed Pharmacother 2001 Nov;55(9-10):519-23
AD - Breast Radiotherapy Services, M.D. Anderson Cancer Center, Houston, TX
77030, USA. mmcneese@mail.mdanderson.org
13
UI - 11882903
AU - Polgar C; Fodor J; Major T; Orosz Z; Nemeth G
TI -
The role of boost irradiation in the conservative treatment of stage
I-II breast cancer.
SO - Pathol Oncol Res 2001;7(4):241-50
AD - National Institute of Oncology, Department of Radiotherapy Rath Gyorgy
u. 7-9., Budapest, H-1122, Hungary. polgar@oncol.hu
In this article, we review the current status, indication, technical
aspects, controversies, and future prospects of boost irradiation after
breast conserving surgery (BCS). BCS and radiotherapy (RT) of the
conserved breast became widely accepted in the last decades for the
treatment of early invasive breast cancer. The standard technique of RT
after breast conservation is to treat the whole breast up to a total
dose of 45 to 50 Gy. However, there is no consensus among radiation
oncologists about the necessity of boost dose to the tumor bed.
Generally accepted criteria for identification of high risk subgroups,
in which boost is recommended, have not been established yet. Further
controversy exists regarding the optimal boost technique (electron vs.
brachytherapy), and their impact on local tumor control and cosmesis.
Based on the results of numerous retrospective and recently published
prospective trials, the European brachytherapy society (GEC-ESTRO), as
well as the American Brachytherapy Society has issued their guidelines
in these topics. These guidelines will help clinicians in their medical
decisions. Some aspects of boost irradiation still remain somewhat
controversial. The final results of prospective boost trials with longer
follow-up, involving analyses based on pathologically defined subgroups,
will clarify these controversies. Preliminary results with recently
developed boost techniques (intraoperative RT, CT-image based 3D
conformal brachytherapy, and 3D virtual brachytherapy) are promising.
However, more experience and longer follow-up are required to define
whether these methods might improve local tumor control for breast
cancer patients treated with conservative surgery and RT.
14
UI - 11839652
AU - Kouloulias VE; Dardoufas CE; Kouvaris JR; Gennatas CS; Polyzos AK; Gogas
TI -
HJ; Sandilos PH; Uzunoglu NK; Malas EG; Vlahos LJ
Liposomal doxorubicin in conjunction with reirradiation and local
hyperthermia treatment in recurrent breast cancer: a phase I/II trial.
SO - Clin Cancer Res 2002 Feb;8(2):374-82
AD - Radiotherapy Department, Areteion University Hospital, Athens.
PURPOSE: This is the first study to evaluate the tolerability and
activity of liposomal doxorubicin (Caelyx; Schering-Plough
Pharmaceuticals) < or =60 mg/km(2) in patients with locally recurrent
breast cancer, when administered in conjunction with reirradiation and
local hyperthermia treatment. EXPERIMENTAL DESIGN: Fifteen female
patients, who had undergone a radical mastectomy and conventional
radiotherapy (60 Gy) in the front chest wall, were entered on a
multimodal protocol consisting of initial treatment with radiotherapy
and a monthly infusion of liposomal doxorubicin < or =60 mg/m(2) in
conjunction with local hyperthermia treatment. All patients received
reirradiation up to a total dose of 30.6 Gy (1.8 Gy/fraction, 5 days a
week). To evaluate the drug's safety, the first 5 patients initially
received a dose of 40 mg/m(2) liposomal doxorubicin, which was then
escalated to 60 mg/m(2). The other 10 patients received 60 mg/m(2) for
all six cycles of chemotherapy. Hyperthermia (HT) was produced in the
region of interest (ROI) using waveguides at a frequency of 433 MHz. The
RSS was obtained from the curves representing the change in the ROI's
surface with time for each patient, as fitted by linear regression.
Linear regression analysis was used to study the relationship between
the time interval from liposomal doxorubicin infusion to HT and the RSS.
RESULTS: At doses of < or =60 mg/m(2), liposomal doxorubicin was well
tolerated, with only mild hematological and nonhematological toxicity.
All patients showed an objective measurable response, with 3 patients
(20%) demonstrating a clinically complete response. There was a
significant correlation between the duration of response and Avg Min
T(90) > 44 degrees C (r(s) = 0.917, P < 0.0001) and the Mean[Tmin] (r(s)
= 0.909, P < 0.0001). The RSS was significantly correlated with the
interval between liposomal doxorubicin infusion and HT, as the smaller
the time interval, the greater the clinical benefit (r = 0.76, P =
0.001). CONCLUSIONS: The multimodal treatment was effective and well
tolerated, producing an objective measurable response in all patients.
Local HT had a significant effect on patients' response to the drug. The
relationship between thermal dose and liposomal action requires further
investigation.
15
UI - 11717750
AU - Kariniemi AL; Autio P
TI -
[Angiosarcoma of the breast after radiotherapy]
SO - Duodecim 1998;114(19):1963-5
AD - HYKS Iho- ja allergiasairaala Meilahdentie 2 00250 Helsinki.
16
UI - 11757135
AU - Joensuu H
TI -
[Postoperative radiotherapy should be given also to women with breast
cancer that are over 55 years]
SO - Duodecim 1998;114(24):2607-9
17
UI - 11767790
AU - Rollins G
TI -
Amid controversy, panel recommends postmastectomy radiation therapy for
breast cancer patients with limited lymph node involvement.
SO - Rep Med Guidel Outcomes Res 2001 Feb 8;12(3):1-2, 5
18
UI - 12007955
AU - Polednak AP
TI -
Trends in, and predictors of, breast-conserving surgery and radiotherapy
for breast cancer in Connecticut, 1988-1997.
SO - Int J Radiat Oncol Biol Phys 2002 May 1;53(1):157-63
AD - Connecticut Tumor Registry, Connecticut Department of Public Health, 410
Capitol Avenue, Hartford, CT 06134-0308, USA.
anthony.polednak@po.state.ct.us
PURPOSE: To describe the trends in, and predictors of, use of
breast-conserving surgery (BCS) vs. mastectomy and use of post-BCS
radiotherapy (RT), from 1988 through 1997 among residents of
Connecticut. METHODS AND MATERIALS: Data on surgical and RT procedures
for 16,676 women diagnosed with early-stage (localized to the breast or
with regional lymph node involvement) invasive breast cancer in
1988-1997 were obtained from the population-based Connecticut Tumor
Registry. RESULTS: Use of BCS (vs. mastectomy) increased over time and
was lower for patients with nodal involvement or larger tumors. The
absence of RT facilities at the hospital of first admission was
negatively associated with BCS but not with post-BCS RT. Post-BCS RT was
low among patients diagnosed at age 80+ years but increased over time
only in this age group. CONCLUSION: Absence of RT at the hospital may be
a deterrent to BCS. The temporal increase in post-BCS RT among patients
diagnosed at age > or =80 years suggests changes in physicians'
attitudes and/or patient preferences that require further study.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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