Open Access Highly Accessed Research article

Re-surgery and chest wall re-irradiation for recurrent breast cancer - a second curative approach

Arndt-Christian Müller1*, Franziska Eckert1, Vanessa Heinrich1, Michael Bamberg1, Sara Brucker2 and Thomas Hehr3

Author Affiliations

1 Department of Radiooncology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany

2 Department of Gynecology, Eberhard-Karls-University, Calwerstr. 7, 72076 Tübingen, Germany

3 Department of Radiooncology, Marienhospital Stuttgart, Böheimstr. 37, 70199 Stuttgart, Germany

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BMC Cancer 2011, 11:197  doi:10.1186/1471-2407-11-197

Published: 25 May 2011

Abstract

Background

Repeat radiation is a rarely used treatment strategy that must be performed with caution. The efficacy and toxicity of a second curative radiotherapy series was investigated in cases of recurrent breast cancer.

Methods

Forty-two patients treated from 1993 to 2003 with resection (n = 30) and postoperative re-irradiation or definitive re-irradiation (n = 12) for recurrent breast cancer were enrolled in the study. Concurrent hyperthermia was performed in 29 patients. The median age was 57 years. The median pre-radiation exposure was 54Gy. Re-irradiation was conventionally fractionated to a median total dose of 60Gy.

Results

After a median follow-up of 41 months (range 3-92 months) higher graded late toxicity > G3 according to CTC 3.0 and LENT-SOMA was not observed. The estimated 5-year local control rate reached 62%. The estimated 5-year overall survival rate was 59%. Significantly inferior survival was associated with recurrence within two years (40 vs. 71%, p < ([0-9]).01) and presence of macroscopic tumour load (24 vs. 75%, p = 0.03).

Conclusions

Repeat radiotherapy for recurrent breast cancer with total radiation doses of 60 Gy and the addition of hyperthermia in the majority of patients was feasible, with acceptable late morbidity and improved prognosis, particularly in patients with previous resection of recurrent tumours.