Clinical and dosimetric evaluation of recurrent breast cancer patients treated with hyperthermia and radiation

Figures & data

Table 1. Patient characteristics at time of breast cancer recurrence (n = 36).

Patient characteristic	Number of patients (range or %)
Age (median)	59.5 (36–85)
Tumor grade
1	2 (5.6)
2	7 (19.4)
3	20 (55.6)
N/A	7 (19.4)
Right/Left breast/chest wall
Right	12 (33.3)
Left	15 (41.7)
Both	9 (25.0)
Histology
Infiltrating ductal carcinoma	25 (83.3)
Inflammatory	4 (11.1)
N/A	7 (19.4)
Tumor volume (median cc)	573.9 (11.7–3619.8)

Figure 1. Kaplan–Meier curve of local control.

Table 2. Response rates of recurrent breast cancer patients treated with hypethermia and radiation (n = 36).

Response	Number of Patients (%)
Complete response (CR)	17 (47.2)
Partial response (PR)	5 (13.9)
Stable disease (SD)	11 (30.6)
Progressive disease (PD)	3 (8.3)

Table 3. Side effects of treatment.

Side effect	Number of patients (%)
Acute
Pain	13 (36.1)
Erythema	10 (27.8)
Edema	6 (16.7)
Blisters	5 (13.9)
Dermatitis	4 (11.1)
Fatigue	3 (8.3)
Ulceration	2 (5.6)
Nausea	1 (2.8)
Scarring/fibrosis	1 (2.8)
None	10 (27.8)
Long-term
Hyperpigmentation/tanning	8 (22.2)
Lymphedema	6 (16.7)
Scarring/fibrosis	5 (13.9)
Shortness of breath	1 (2.8)
Ulceration
Present before treatment	3 (8.3)
Post-treatment	3 (8.3)
Pain	2 (5.6)
Telangiectasias	2 (5.6)
None	10 (27.8)

Figure 2. Scatterplots of treatment volumes, lung and heart doses by treatment technique. (A) Planning treatment volumes, (B) mean lung dose, and (C) percentage of ipsilateral lung receiving greater than 5 Gy are shown for all patients. (D) Mean heart dose for all patients receiving conventional photon and IMRT plans. (E) Mean heart dose for patients receiving left-sided treatments only.

Figure 3. Pre- and post-treatment images and radiation plan for a patient with extensive triple negative breast cancer recurrence treated with hyperthermia and IMRT. (A). Pretreatment (left) and 1 month post-treatment (right) images of a patient with recurrent cancer involving bilateral chest wall and left arm. (B) Radiation dose distributions on axial (left), coronal (middle), and sagittal (right) images for the patient. The PTV is shaded in yellow and treated to 32 Gy. Isodose lines are shown: 35.2 Gy (red), 32.0 Gy (green), 28.8 Gy (purple), 22.4 Gy (orange), 16.0 Gy (blue). (C) Dose volume histogram (DVH) for the PTV, lung, heart, spinal cord and liver are shown.

Figure 4. Pre- and post-treatment images and radiation plan for a patient with extensive ER + PR + Her2+ breast cancer recurrence treated with hyperthermia and IMRT. (A) Pretreatment (left) and 2 months post-treatment (right) images of a patient with recurrent Her2+ breast cancer. (B) Radiation dose distributions on axial (top), coronal (bottom left) and sagittal (bottom right) images for the patient. The PTV is shaded in red and treated to 46 Gy. Isodose lines are shown: 50 Gy (yellow), 46 Gy (green), 36 Gy (pink), 20 Gy (blue). (C) Dose volume histograms (DVH) for the PTV, heart, lung, small bowel, liver, kidney, spinal cord and stomach are shown.