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Wahl AO , Rademaker A , Kiel KD , Jones EL , Marks LB , Croog V , McCormick BM , Hirsch A , Karkar A , Motwani SB , Tereffe W , Yu TK , Sher D , Silverstein J , Kachnic LA , Kesslering C , Freedman GM , Small W
Multi-institutional review of repeat irradiation of chest wall and breast for recurrent breast cancer
International Journal of Radiation Oncology Biology Physics. 2008 Feb;70(2) :477-484
PMID: ISI:000252521700024   
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Purpose: To review the toxicity and clinical outcomes for patients who underwent repeat chest wall or breast irradiation (RT) after local recurrence. Methods and Materials: Between 1993 and 2005, 81 patients underwent repeat RT of the breast or chest wall for locally recurrent breast cancer at eight institutions. The median dose of the first course of RT was 60 Gy and was 48 Gy for the second course. The median total radiation dose was 106 Gy (range, 74.4-137.5 Gy). At the second RT course, 20% received twice-daily RT, 54% were treated with concurrent hyperthermia, and 54% received concurrent chemotherapy. Results: The median follow-up from the second RT course was 12 months (range, 1-144 months). Four patients developed late Grade 3 or 4 toxicity. However, 25 patients had follow-up >20 months, and no late Grade 3 or 4 toxicities were noted. No treatment-related deaths occurred. The development of Grade 3 or 4 late toxicity was not associated with any repeat RT variables. The overall complete response rate was 57%. No repeat RT parameters were associated with an improved complete response rate, although a trend was noted for an improved complete response with the addition of hyperthermia that was close to reaching statistical significance (67% vs. 39%, p = 0.08). The 1-year local disease-free survival rate for patients with gross disease was 53% compared with 100% for those without gross disease (p < 0.0001). Conclusions: The results of our study have shown that repeat RT of the chest wall for patients with locally recurrent breast cancer is feasible, because it is associated with acceptable acute and late morbidity and encouraging local response rates. (C) 2008 Elsevier Inc.
ISI Document Delivery No.: 253MG Times Cited: 0 Cited Reference Count: 46 Cited References: ABERIZK WJ, 1986, CANCER, V58, P12 ABNER AL, 1993, J CLIN ONCOL, V11, P44 ALPERT TE, 2005, INT J RADIAT ONCOL, V63, P845 BARTELINK H, 2001, NEW ENGL J MED, V345, P1378 BECK TM, 1983, J CLIN ONCOL, V1, P400 BEDWINEK J, 1994, SEMIN RADIAT ONCOL, V4, P260 BEDWINEK JM, 1981, CANCER, V47, P2232 CAJUCOM CC, 1993, CANCER, V71, P1774 DAHLSTROM KK, 1993, CANCER, V72, P774 DALBERG K, 1998, BREAST CANCER RES TR, V49, P69 DEUTCH M, 1986, INT J RADIAT ONCOL, V1219, P2061 DEUTSCH M, 2002, INT J RADIAT ONCOL, V53, P687 DOYLE T, 2001, INT J RADIAT ONCOL, V51, P74 DRAGOVIC J, 1989, J CLIN ONCOL, V7, P30 ELKORT RJ, 1980, CANCER, V46, P647 FISHER B, 1991, LANCET, V338, P327 FISHER B, 2002, NEW ENGL J MED, V347, P1233 FOURQUET A, 1989, INT J RADIAT ONCOL, V17, P719 HALVERSON KJ, 1990, INT J RADIAT ONCOL, V19, P851 HARIMA Y, 2001, INT J HYPERTHER, V17, P97 HORWITZ EM, 2005, INT J RAD ONCOL BI S, V63, P72 HUANG E, 2002, CANCER, V95, P2059 JONES EL, 2005, J CLIN ONCOL, V23, P3079 KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457 KOULOULIAS VE, 2002, CLIN CANCER RES, V8, P374 KURTZ JM, 1991, EUR J CANCER, V27, P240 LARAMORE GE, 1978, CANCER, V41, P991 LI G, 2004, INT J CLIN ONCOL, V9, P179 NIELSEN HM, 2006, J CLIN ONCOL, V24, P2268 OVERGAARD J, 1995, LANCET, V345, P540 OVERGAARD M, 1997, NEW ENGL J MED, V337, P947 OVERGAARD M, 1999, LANCET, V353, P1641 PHROMRATANAPONG.P, 1991, STRAHLENTHER ONKOL, V167, P93 POLTINNIKOV IM, 2005, INT J RADIAT ONCOL, V62, P652 RAGAZ J, 2005, J NATL CANCER I, V97, P116 SALVADORI B, 1999, BRIT J SURG, V86, P84 SCHWAIBOLD F, 1991, INT J RADIAT ONCOL, V21, P299 SNEED PK, 1998, INT J RADIAT ONCOL, V40, P287 STADLER B, 1987, RADIOTHER ONCOL, V8, P105 TROTTI A, 2003, SEMIN RADIAT ONCOL, V13, P176 VALENTINI V, 2006, INT J RADIAT ONCOL, V64, P1129 VANDERZEE J, 1999, BRIT J CANCER, V79, P483 VERON CC, 1996, INT J RADIAT ONCOL, V35, P731 VICINI FA, 1992, J NCI MONOGR, V11, P33 VOOGD AC, 1999, CANCER, V85, P437 WAGMAN R, 2002, INT J RADIAT ONCOL, V54, S237 Wahl, Andrew O. Rademaker, Alfred Kiel, Krystyna D. Jones, Ellen L. Marks, Lawrence B. Croog, Victoria Mccormick, Beryl M. Hirsch, Arica Karkar, Ami Motwani, Sabin B. Tereffe, Welela Yu, Tse-Kuan Sher, David Silverstein, Joshua Kachnic, Lisa A. Kesslering, Christy Freedman, Gary M. Small, William, Jr. ELSEVIER SCIENCE INC; 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA