Durable palliation of breast cancer chest wall recurrence with radiation therapy, hyperthermia, and chemotherapy.


Journal Article

Chest wall recurrences of breast cancer are a therapeutic challenge and durable local control is difficult to achieve. Our objective was to determine the local progression free survival (LPFS) and toxicity of thermochemoradiotherapy (ThChRT) for chest wall recurrence.Twenty-seven patients received ThChRT for chest wall failure from 2/1995 to 6/2007 and make up this retrospective series. All received concurrent superficial hyperthermia twice weekly (median 8 sessions), chemotherapy (capecitabine in 21, vinorelbine in 2, and paclitaxel in 4), and radiation (median 45 Gy). Patients were followed up every 1.5-3 months and responses were graded with RECIST criteria and toxicities with the NCI CTC v4.0.Twenty-three (85%) patients were previously irradiated (median 60.4 Gy) and 22 (81%) patients received prior chemotherapy. Median follow-up was 11 months. Complete response (CR) was achieved in 16/20 (80%) of patients with follow-up data, and 1 year LPFS was 76%. Overall survival was 23 months for patients with CR, and 5.4 months in patients achieving a partial response (PR) (p=0.01). Twenty-two patients experienced acute grade 1/2 treatment related toxicities, primarily moist desquamation. Two patients experienced 3rd degree burns; all resolved with conservative measures.ThChRT offers durable palliation and prolonged LPFS with tolerable acute toxicity, especially if CR is achieved.

Full Text

Duke Authors

Cited Authors

  • Zagar, TM; Higgins, KA; Miles, EF; Vujaskovic, Z; Dewhirst, MW; Clough, RW; Prosnitz, LR; Jones, EL

Published Date

  • December 2010

Published In

Volume / Issue

  • 97 / 3

Start / End Page

  • 535 - 540

PubMed ID

  • 21074876

Pubmed Central ID

  • 21074876

Electronic International Standard Serial Number (EISSN)

  • 1879-0887

International Standard Serial Number (ISSN)

  • 0167-8140

Digital Object Identifier (DOI)

  • 10.1016/j.radonc.2010.10.020


  • eng