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• W3093848175 abstract "Locoregional management of recurrent breast cancer in patients with a history of ipsilateral breast/chest wall (CW) radiotherapy can be challenging due to concerns regarding normal tissue toxicity with re-irradiation (re-RT). This study assesses toxicities and clinical outcomes in patients who underwent external beam CW and/or regional lymph node (LN) re-RT for locoregional recurrence (LRR). We performed a retrospective review of our institutional database to identify breast cancer patients diagnosed with an isolated ipsilateral breast/CW or nodal recurrence from 2010 to 2019 after prior whole breast/CW irradiation. Locoregional management of recurrent disease included surgical resection and external beam re-RT. Early toxicity outcomes were graded by the treating physician using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. For patients with an intact breast or reconstruction, patient-reported cosmetic outcomes were graded as excellent, good, fair, or poor. Follow-up was calculated from the completion of the second course of RT. Fifteen patients met the study criteria. Median age was 46 (range, 32-72) at initial diagnosis and 55 (range, 38-75) at recurrent diagnosis. Median time between completion of RT courses was 68.3 months (range, 7.8-245.4). Median initial whole breast/CW dose was 50Gy (range, 33.5-50.4). Boost was delivered in 11 (73.3%) patients, and 5 (33.3%) received nodal RT. Nine patients (60.0%) had T1-2 recurrent tumors, and 2 (13.3%) presented with an inflammatory recurrence. Fourteen patients (93.3%) received chemotherapy for recurrence, including 4 (26.7%) who received concurrent chemoRT. Five patients (33.3%) underwent LN evaluation for recurrence. Median total number of LNs removed from all surgeries was 9 (range, 1-31). The majority of patients (80.0%) received proton beam re-RT. Median CW re-RT dose was 45Gy (range, 42.3-50.4), and 7 patients (46.7%) received a boost. The axilla was targeted in 86.7% of patients and the supraclavicular fossa in 73.3%. Grade 2-3 dermatitis occurred in 86.7% patients. Grade 2-3 pain was reported by 33.3% of patients and grade 3 fatigue by 40.0%. There were no acute grade 4 toxicities. Among 8 patients with an intact breast/reconstruction, 5 reported good and 3 reported fair cosmetic outcomes. Two patients (13.3%) developed clinical lymphedema. There were no reports of brachial plexopathy. At a median follow-up of 13.7 months (range, 1.0-90.5), the rate of isolated LRR was 13.3%, overall LRR 26.7%, and distant metastases 33.3%. Re-RT of the CW and/or regional LNs is feasible with acceptable rates of acute and long-term toxicity and low rates (13.3%) of isolated LRR. The majority of patients (80%) were treated with proton beam re-irradiation, which may help to reduce normal tissue toxicity." @default.
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• W3093848175 date "2020-11-01" @default.
• W3093848175 modified "2023-09-25" @default.
• W3093848175 title "Toxicities and Locoregional Control after External Beam Chest Wall and/or Regional Lymph Node Re-irradiation for Recurrent Breast Cancer" @default.
• W3093848175 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1121" @default.
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