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Efficacy of Hyperthermia in Combination with Radiation Therapy for Breast Cancer

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Hyperthermic Oncology from Bench to Bedside
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Abstract

Hyperthermia continues to show clinical benefits in randomized trials across a spectrum of malignancies, with generally well-tolerated side effects when administered as multimodality therapy. Hyperthermia contributes to direct tumor cell killing, and may also enhance the antitumor effects of chemotherapy and radiation therapy. Particularly, hyperthermia has been shown to be beneficial for treating superficial malignancies, such as chest wall recurrence of breast cancer. Although much evidence has been gained from clinical trials and studies of hyperthermia, regular use has not yet been established for breast cancer treatment. In this review article, we will highlight the benefits of therapeutic hyperthermia and the combined use of hyperthermia and radiation, and overview the results reported from clinical trials.

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References

  1. Fisher B, Slack NH, Cavanaugh PJ, Gardner B, Ravdin RG. Postoperative radiotherapy in the treatment of breast cancer: results of the NSABP clinical trial. Ann Surg. 1970;172:711–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Lee MC, Jagsi R. Postmastectomy radiation therapy: indications and controversies. Surg Clin North Am. 2007;87:511–26.

    Article  PubMed  Google Scholar 

  3. Taghian A, Jeong JH, Mamounas E, Anderson S, Bryant J, Deutsch M, Wolmark N. Patterns of locoregional failure in patients with operable breast cancer treated by mastectomy and adjuvant chemotherapy with or without tamoxifen and without radiotherapy: results from five national surgical adjuvant breast and bowel project randomized clinical trials. J Clin Oncol. 2004;22:4247–54.

    Article  PubMed  Google Scholar 

  4. Katz A, Strom EA, Buchholz TA, Thames HD, Smith CD, Jhingran A, Hortobagyi G, Buzdar AU, Theriault R, Singletary SE, et al. Locoregional recurrence patterns after mastectomy and doxorubicin-based chemotherapy: implications for postoperative irradiation. J Clin Oncol. 2000;18:2817–27.

    CAS  PubMed  Google Scholar 

  5. Nielsen HM, Overgaard M, Grau C, Jensen AR, Overgaard J. Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies. J Clin Oncol. 2006;24:2268–75.

    Article  PubMed  Google Scholar 

  6. Ragaz J, Olivotto IA, Spinelli JJ, Phillips N, Jackson SM, Wilson KS, Knowling MA, Coppin CM, Weir L, Gelmon K, et al. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst. 2005;97:116–26.

    Article  PubMed  Google Scholar 

  7. MacDonald SM, Abi-Raad RF, Alm El-Din MA, Niemierko A, Kobayashi W, McGrath JJ, Goldberg SI, Powell S, Smith B, Taghian AG. Chest wall radiotherapy: middle ground for treatment of patients with one to three positive lymph nodes after mastectomy. Int J Radiat Oncol Biol Phys. 2009;75:1297–303.

    Article  PubMed  Google Scholar 

  8. Perez LA, Brady LW. Breast cancer: locally advanced, inflammatory and recurrent tumors. Philadelphia: Lippincott; 2003.

    Google Scholar 

  9. De Vita V, Hellman S, Rosenberg SA. Cancer of the breast. In: De Vita V, Hellman S, Rosenberg SA, editors. Cancer. Philadelphia: Lippincott; 2001.

    Google Scholar 

  10. Dunst J, Steil B, Furch S, Fach A, Lautenschlager C, Diestelhorst A, Lampe D, Kolbl H, Richter C. Prognostic significance of local recurrence in breast cancer after postmastectomy radiotherapy. Strahlenther Onkol. 2001;177:504–10.

    Article  CAS  PubMed  Google Scholar 

  11. Bedwinek JM, Lee J, Fineberg B, Ocwieza M. Prognostic indicators in patients with isolated localregional recurrence of breast cancer. Cancer. 1981;47:2232–5.

    Article  CAS  PubMed  Google Scholar 

  12. Chu FC, Lin FJ, Kim JH, Huh SH, Garmatis CJ. Locally recurrent carcinoma of the breast. Results of radiation therapy. Cancer. 1976;37:2677–81.

    Article  CAS  PubMed  Google Scholar 

  13. Bedwinek J. Natural history and management of isolated local-regional recurrence following mastectomy. Semin Radiat Oncol. 1994;4:260–9.

    Article  PubMed  Google Scholar 

  14. Beck TM, Hart NE, Woodard DA, Smith CE. Local or regionally recurrent carcinoma of the breast: results of therapy in 121 patients. J Clin Oncol. 1983;1:400–5.

    CAS  PubMed  Google Scholar 

  15. Willner J, Kiricuta IC, Kolbl O. Locoregional recurrence of breast cancer following mastectomy: always a fatal event? Results of univariate and multivariate analysis. Int J Radiat Oncol Biol Phys. 1997;37:853–63.

    Article  CAS  PubMed  Google Scholar 

  16. Chagpar A, Meric-Bernstam F, Hunt KK, Ross MI, Cristofanilli M, Singletary SE, Buchholz TA, Ames FC, Marcy S, Babiera GV, et al. Chest wall recurrence after mastectomy does not always portend a dismal outcome. Ann Surg Oncol. 2003;10:628–34.

    Article  PubMed  Google Scholar 

  17. Kamby C, Sengelov L. Pattern of dissemination and survival following isolated locoregional recurrence of breast cancer. A prospective study with more than 10 years of follow up. Breast Cancer Res Treat. 1997;45:181–92.

    Article  CAS  PubMed  Google Scholar 

  18. Halverson KJ, Perez CA, Kuske RR, Garcia DM, Simpson JR, Fineberg B. Survival following locoregional recurrence of breast cancer: univariate and multivariate analysis. Int J Radiat Oncol Biol Phys. 1992;23:285–91.

    Article  CAS  PubMed  Google Scholar 

  19. Hsi RA, Antell A, Schultz DJ, Solin LJ. Radiation therapy for chest wall recurrence of breast cancer after mastectomy in a favorable subgroup of patients. Int J Radiat Oncol Biol Phys. 1998;42:495–9.

    Article  CAS  PubMed  Google Scholar 

  20. Schmoor C, Sauerbrei W, Bastert G, Schumacher M. Role of isolated locoregional recurrence of breast cancer: results of four prospective studies. J Clin Oncol. 2000;18:1696–708.

    CAS  PubMed  Google Scholar 

  21. Mora EM, Singletary SE, Buzdar AU, Johnston DA. Aggressive therapy for locoregional recurrence after mastectomy in stage II and III breast cancer patients. Ann Surg Oncol. 1996;3:162–8.

    Article  CAS  PubMed  Google Scholar 

  22. Breasted JH. The Edwin Smith surgical papyrus. Chicago: University of Chicago Oriental Institute Publications; 1930.

    Google Scholar 

  23. Westermark F. Uber die Behandlung des Ulceriereden Cervixcarcinoma mittels konstanter warme. Zbl Gynakol. 1898;22:1335–9.

    Google Scholar 

  24. Coley WB. The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. 1893. Clin Orthop Relat Res. 1991;262:3–11.

    Google Scholar 

  25. Kouloulias V, Triantopoulou S, Uzunoglou N, Pistevou-Gompaki K, Barich A, Zygogianni A, Kyrgias G, Kardamakis D, Pectasidis D, Kouvaris J. Hyperthermia is now included in the NCCN clinical practice guidelines for breast cancer recurrences: an analysis of existing data; Greek society of hyperthermic oncology. Breast Care (Basel). 2015;10:109–16.

    Article  Google Scholar 

  26. Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz M, Goldstein LJ, Hudis CA, Isakoff SJ, Marcom PK, Mayer IA, McCormick B, Moran M, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith KL, Smith ML, Soliman H, Somlo G, Telli M, Ward JH, Shead DA, Kumar R. Breast cancer version 1.2016. J Natl Compr Canc Netw. 2015;13(12):1475–85.

    PubMed  Google Scholar 

  27. Lepock JR. Cellular effects of hyperthermia: relevance to the minimum dose for thermal damage. Int J Hyperthermia. 2003;19:252–66.

    Article  CAS  PubMed  Google Scholar 

  28. MivechiNF DWC. DNApolymerase alpha and beta activities during the cell cycle and their role in heat radiosensitization in Chinese hamster ovary cells. Radiat Res. 1985;103:337–50.

    Article  Google Scholar 

  29. Armour EP, McEachern D, Wang Z, et al. Sensitivity of human cells to mild hyperthermia. Cancer Res. 1993;53:2740–4.

    CAS  PubMed  Google Scholar 

  30. Koutcher JA, Barnett D, Kornblith AB, et al. Relationship of changes in pH and energy status to hypoxic cell fraction and hyperthermia sensitivity. Int J Radiat Oncol Biol Phys. 1990;18:14291435.

    Article  Google Scholar 

  31. Engin K, Leeper D, Thistlethwaite A, et al. Tumor extracellular pH as a prognostic factor in thermoradiotherapy. Int J Radiat Oncol Biol Phys. 1994;29:125–32.

    Article  CAS  PubMed  Google Scholar 

  32. Song CW. Effect of local hyperthermia on blood flow and microenvironment: a review. Cancer Res. 1984;44:4721s–30.

    CAS  PubMed  Google Scholar 

  33. Lindholm CE, Kjellen E, Nilsson P, Hertzman S. Microwave-induced hyperthermia and radiotherapy in human superficial tumours: clinical results with a comparative study of combined treatment versus radiotherapy alone. Int J Hyperthermia. 1987;3(5):393–411.

    Article  CAS  PubMed  Google Scholar 

  34. Lindholm CE, Kjellén E, Nilsson P, Weber L, Hill S. Prognostic factors for tumour response and skin damage to combined radiotherapy and hyperthermia in superficial recurrent breast carcinomas. Int J Hyperthermia. 1995;11(3):337–55.

    Article  CAS  PubMed  Google Scholar 

  35. Moros EG, Peñagaricano J, Novàk P, Straube WL, Myerson RJ. Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer. Int J Hyperthermia. 2010;26(7):699–709.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Zagar TM, Oleson JR, Vujaskovic Z, Dewhirst MW, Craciunescu OI, Blackwell KL, Prosnitz LR, Jones EL. Hyperthermia combined with radiation therapy for superficial breast cancer and chest wall recurrence: a review of the randomised data. Int J Hyperthermia. 2010;26(7):612–17.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Jones EL, Oleson JR, Prosnitz LR, Samulski TV, Vujaskovic Z, Yu D, Sanders LL, Dewhirst MW. Randomized trial of hyperthermia and radiation for superficial tumors. J Clin Oncol. 2005;23(13):3079–85.

    Article  PubMed  Google Scholar 

  38. Refaat T, Sachdev S, Sathiaseelan V, Helenowski I, Abdelmoneim S, Pierce MC, Woloschak G, Small Jr W, Mittal B, Kiel KD. Hyperthermia and radiation therapy for locally advanced or recurrent breast cancer. Breast. 2015;24(4):418–25.

    Article  PubMed  Google Scholar 

  39. Linthorst M, Baaijens M, Wiggenraad R, Creutzberg C, Ghidey W, van Rhoon GC, van der Zee J. Local control rate after the combination of re-irradiation and hyperthermia for irresectable recurrent breast cancer: results in 248 patients. Radiother Oncol. 2015;117(2):217–22.

    Article  PubMed  Google Scholar 

  40. Yamamoto D, Inui T, Tsubota Y, Sueoka N, Yamamoto C, Kuwana K, Yamamoto M. The utility of hyperthermia for local recurrence of breast cancer. World J Surg Oncol. 2012;10:201.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Overgaard J. The heat is (still) on – the past and future of hyperthermic radiation oncology. Radiother Oncol. 2013;109(2):185–7.

    Article  PubMed  Google Scholar 

  42. Januszewski A, Stebbing J. Hyperthermia in cancer: is it coming of age? Lancet Oncol. 2014;15(6):565–6.

    Article  PubMed  Google Scholar 

  43. Mathis S, Johansson T. Hyperthermia. Decision support document 36. Vienna: Ludwig Boltzmann Institute for heath technology assessment 2010, 1992–0496. Available at http://esprints.hta.lbg.ac.at

  44. Wild C. Should hyperthermia be included in the benefit catalogue for oncologic indications? Commercial interests are presumed behind the editorial of R Sauer et al. Strahlenther Onkol. 2013;189(1):81–6.

    Article  CAS  PubMed  Google Scholar 

  45. van der Zee J, Vujaskovic Z, Kondo M, Sugahara T. The kadota fund international forum 2004 – clinical group consensus. Int J Hyperthermia. 2008;24(2):111–22.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Sauer R, Crezee H, Hulshof M, et al. The letter of the Ludwig Boltzamann Institute is unnecessarily polarizing to the discussion on whether or not hyperthermia is evidence based. Strahlenther Onkol. 2013;189:84–6.

    Article  Google Scholar 

  47. Issels RD. Hyperthermia adds to chemotherapy. Eur J Cancer. 2008;44(17):2546–54.

    Article  CAS  PubMed  Google Scholar 

  48. Horsman MR, Overgaard J. Hyperthermia: a potent enhancer of radiotherapy. Clin Oncol (R Coll Radiol). 2007;19(6):418–26.

    Article  CAS  Google Scholar 

  49. Lammers RJ, Witjes JA, Inman BA, Leibovitch I, Laufer M, Nativ O, Colombo R. The role of a combined regimen with intravesical chemotherapy and hyperthermia in the management of non-muscle-invasive bladder cancer: a systematic review. Eur Urol. 2011;60(1):81–93.

    Article  PubMed  Google Scholar 

  50. Mi DH, Li Z, Yang KH, Cao N, Lethaby A, Tian JH, Santesso N, Ma B, Chen YL, Liu YL. Surgery combined with intraoperative hyperthermic intraperitoneal chemotherapy (IHIC) for gastric cancer: a systematic review and meta-analysis of randomised controlled trials. Int J Hyperthermia. 2013;29(2):156–67.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Daigo Yamamoto .

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Yamamoto, D., Yamamoto, C., Iwase, S., Odagiri, H. (2016). Efficacy of Hyperthermia in Combination with Radiation Therapy for Breast Cancer. In: Kokura, S., Yoshikawa, T., Ohnishi, T. (eds) Hyperthermic Oncology from Bench to Bedside. Springer, Singapore. https://doi.org/10.1007/978-981-10-0719-4_18

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  • DOI: https://doi.org/10.1007/978-981-10-0719-4_18

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