Abstract
Since 1979, we have treated patients with recurrent breast cancer in previously irradiated areas with a combination of (relatively) low doses of radiotherapy and hyperthermia. During the earlier years, the reirradiation dose was very low, but, based on experience, gradually increased to 32 Gy. Analysis of the first 97 patients shows that the chance to achieve a complete response increased with smaller volumes and an increasing radiotherapy dose. The radiation schedule of 8×4 Gy in 4 weeks, combined with hyperthermia, appears safe, effective (61% complete response) and well tolerated. Analysis of the results with 54 evaluable patients treated more recently with the same reirradiation plus hyperthermia schedule shows a remarkable increase in chance to achieve a complete response: to 83%. These improved results reflect the development and use of a better heating technique. The steep increase in complete response rate for larger tumors indicates that the therapeutic gain from “good quality” hyperthermia in addition to radiotherapy indeed may be considerable.
Zusammenfassung
Wir behandeln seit 1979 Patientinnen mit Brustwandezidiven von Mammakarzinomen in vorher bestrahltem Gewebe mit einer Kombination von Bestrahlung und Lokalhyperthermie. In den ersten Jahren war die Bestrahlungsdosis sehr niedrig, aber mit steigender Erfahrung allmählich erhöht bis zu 32 Gy. Die Analyse der ersten 97 Patientinnen zeigte, daß die Chance auf eine vollständige Remission mit kleinerem Tumorvolumen und zunehmender Strahlungsdosis wächst. Das Bestrahlungsschema von 8×4 Gy in 4 Wochen, kombiniert mit Hyperthermie, erwies sich als effektive (61% vollständige Remissionen), sichere (akzeptable Nebenwirkungen) und gut verträgliche Behandlung. Die Analyse von 54 weiteren Patientinnen, die später mit dem gleichen Behandlungsschema behandelt wurden, zeigt ein auffällige Besserung der klinische Ergebnisse: Die Chance auf eine vollständige Remission hat sich auf 83% gesteigert. Diese Besserung der Behandlungsergebnisse ist eine Folge der Entwicklung und benutzung einer optimierten Behandlungstechnik. Die hohe Zunahme der Complete-response-Chance von größeren Tumoren zeigt die
Bedeutung und den therapeutische Gewinn einer qualitativ guten Hyperthermiebehandlung.
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van der Zee, J., van Rhoon, G.C., Treurniet-Donker, A.D. et al. Local hyperthermia in recurrent breast cancer treatment. Acta Chir Austriaca 24, 218–222 (1992). https://doi.org/10.1007/BF02601749
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DOI: https://doi.org/10.1007/BF02601749