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Helical Tomotherapy of Lymph Node-negative Early-stage Breast Cancer After Breast-conserving Surgery : Long-term Results

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2023

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Zwicker, Felix
Klepper, Rudolf
Hauswald, Henrik
Raether , Luis
Huber, Peter E.
Debus, Juergen

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Anticancer Research. International Institute of Anticancer Research. 2023, 43(5), pp. 2041-2053. ISSN 0250-7005. eISSN 1791-7530. Available under: doi: 10.21873/anticanres.16365

Zusammenfassung

Background/Aim: Adjuvant radiotherapy is an integral part of the interdisciplinary curative treatment of breast cancer. We aimed to examine the long-term clinical results of helical tomotherapy in female patients with local restricted, lymph node negative breast cancer after breast-conserving surgery.
Patients and Methods: In this single-centre analysis, 219 female patients with early-stage breast cancer (T1/2) and no lymph node metastasis (N0) following breast-conserving surgery and sentinel-node biopsy were treated with adjuvant fractionated whole breast radiation therapy using helical tomotherapy. When boost irradiation was indicated, it was administered sequentially or using the simultaneous-integrated boost technique. Local control (LC), metastasis and survival rates, acute toxicity, late toxicity, and secondary malignancy rates were analysed retrospectively.
Results: The mean follow-up time was 71 months. The 5- and 8-year overall survival (OS) rates were 97.7% and 92.1%, respectively. The 5- and 8-year LC rates were 99.5% and 98.2%, while the 5- and 8-year metastasis-free survival (MFS) rates of 97.4% and 94.3%, respectively. Patients with G3 grading or negative hormone receptor status did not show significantly different results. Acute erythema occurred in 79% (grade 0-2) and 21% (grade 3) of the patients. Lymphedema of the ipsilateral arm and pneumonitis occurred in 6.4% and 1.8% of the treated patients. None of the patients developed >grade 3 toxicities during follow-up, while 1.8% developed a secondary malignancy during follow-up.
Conclusion: Helical tomotherapy showed excellent long-term results and low toxicity rates. The incidence rates of secondary malignancy were relatively low and correlated with pre-existing data on radiotherapy, suggesting wider implementation of helical tomotherapy in adjuvant radiotherapy for breast cancer patients.

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ISO 690ZWICKER, Felix, Rudolf KLEPPER, Henrik HAUSWALD, Sebastian HÖFEL, Luis RAETHER , Peter E. HUBER, Juergen DEBUS, Michael SCHEMPP, 2023. Helical Tomotherapy of Lymph Node-negative Early-stage Breast Cancer After Breast-conserving Surgery : Long-term Results. In: Anticancer Research. International Institute of Anticancer Research. 2023, 43(5), pp. 2041-2053. ISSN 0250-7005. eISSN 1791-7530. Available under: doi: 10.21873/anticanres.16365
BibTex
@article{Zwicker2023Helic-68773,
  year={2023},
  doi={10.21873/anticanres.16365},
  title={Helical Tomotherapy of Lymph Node-negative Early-stage Breast Cancer After Breast-conserving Surgery : Long-term Results},
  number={5},
  volume={43},
  issn={0250-7005},
  journal={Anticancer Research},
  pages={2041--2053},
  author={Zwicker, Felix and Klepper, Rudolf and Hauswald, Henrik and Höfel, Sebastian and Raether , Luis and Huber, Peter E. and Debus, Juergen and Schempp, Michael}
}
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