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

Abstract

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.

• Authors: Felix Zwicker, Rudolf Klepper, Henrik Hauswald, Sebastian Hoefel, Luis Raether, Peter E Huber, Juergen Debus, Michael Schempp
• Journal: Anticancer research (Anticancer Res) Vol. 43 Issue 5 Pg. 2041-2053 (May 2023) ISSN: 1791-7530 [Electronic] Greece
• PMID: 37097694 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Topics

• Female
• Humans
• Breast Neoplasms (radiotherapy, surgery, pathology)
• Radiotherapy, Intensity-Modulated (adverse effects, methods)
• Retrospective Studies
• Mastectomy, Segmental
• Sentinel Lymph Node Biopsy
• Radiotherapy, Adjuvant (adverse effects, methods)