Radiotherapy and hyperthermia for breast cancer patients at high risk of recurrence

Figures & data

Figure 1. Distribution of relapse events according to site of relapse (local, regional or distant).

Table 1. Patients, tumor, and treatment characteristics at the time of treatment with RT + HT.

RT + HT total	196 (100%)
Recurrent BC previously irradiated	93 (47.4%)
Recurrent BC not previously irradiated	61 (31.1%)
First diagnosed BC	42 (21.4%)
Age (mean, range)	60 (30-88)
pT stage
1	44 (22.4%)
2	41 (20.9%)
3	13 (6.6%)
4	42 (21.4%)
Unknown	56 (28.6%)
pN stage
0	38 (19.4%)
1	28 (14.3%)
2	13 (6.6%)
3	14 (7.1%)
Unknown	103 (52.6%)
M stage
0	138 (70.4%)
1	37 (18.9%)
Unknown	21 (10.7%)
Histology
Invasive ductal	120 (61.2%)
Invasiv lobular	38 (19.4%)
Other	25 (12.8%)
Unknown	13 (6.6%)
ER/PR expression
Positive	141 (71.9%)
Negative	53 (27%)
Unknown	2 (1%)
Her2 expression
Positive	31 (15.8%)
Negative	138 (70.4%)
Unknown	27 (13.8%)
Grading
1	2 (1%)
2	83 (42.3%)
3	79 (40.3%)
Unknown	32 (16.3%)
Resection margins
R0	24 (12.2%)
Close	52 (26.5%)
R1	66 (33.7%)
R2	17 (8.7%)
Inoperable	28 (14.3%)
Unknown	9 (4.6%)
RT dose (Gy, mean, range)	57 (28–72)
<50 Gy	13 (6.6%)
≥50 Gy <60 Gy	77 (39.3%)
≥60 Gy <70 Gy	99 (50.5%)
≥70 Gy	7 (3.6%)
HT temperature
Average (°C, mean, range)	39.6 (36.8–41.6)
Minimal (°C, mean, range)	38.5 (35.1–43)
Maximal (°C, mean, range)	41.3 (39.8–45.8)
HT fractions number (mean, range)	10 (1–15)

Figure 2. Kaplan–Meier curves for local control (A), overall survival (B), progression-free survival (C) and for local control according to resection status (D), number of HT fractions (E) and combined resection status with applied radiation dose (F).

Table 2. Univariate analysis for local control.

	HR	95 CI lower	95 CI upper	p
T stage (1–2 vs. 2–4)	0.33	0.17	0.65	0.009
N stage (0–1 vs. 2–3)	1.47	0.55	3.96	0.49
M stage (0 vs. 1)	0.46	0.19	1.09	0.02
ER/PR (neg. vs. pos.)	3.31	1.64	6.69	<0.0001
Her2 (neg. vs. pos.)	0.97	0.44	2.12	0.94
Grading (G1–2 vs. G3)	0.57	0.31	1.04	0.07
Resection margins (R0-close-R1 vs. R2-inop.)	0.43	0.21	0.91	0.005
Reirradiation (Re-RT + HT vs. RT + HT)	1.47	0.72	2.76	0.32
RT dose (<60 Gy vs. ≥ 60 Gy)	1.46	0.82	2.57	0.18
HT average temperature (<39.6 °C vs. ≥39.6 °C)	0.9	0.44	1.4	0.4
HT minimal temperature (<38.5 °C vs. ≥38.5 °C)	1.56	0.83	2.98	0.13
HT maximal temperature (<41.3 °C vs. ≥41.3 °C)	0.92	0.51	1.64	0.77
HT fractions number (<10 vs. ≥10)	1.92	1.05	3.54	0.02

Statistically significant results (p < 0.05) are indicated in bold. Hazard ratio (HR), with 95% confidence interval (CI) is reported.

Table 3. Multivariate analysis for local control.

	HR	95 CI lower	95 CI upper	p
T stage (1–2 vs. 2–4)	0.37	0.15	0.94	0.04
M stage (0 vs. 1)	0.48	0.19	1.24	0.13
ER/PR (neg. vs pos.)	4.7	2.13	10.36	<0.0001
Grading (G1–2 vs. G3)	0.74	0.33	1.66	0.47
Resection margins (R0-close-R1 vs. R2-inop.)	1.13	0.25	5.07	0.87
HT fractions number (<10 vs. ≥ 10)	1.57	0.7	3.54	0.27

Statistically significant results (p < 0.05) are indicated in bold. Hazard ratio (HR), with 95% confidence interval (CI) is reported.

Figure 3. Acute (A) and late (B) skin toxicity.