Reirradiation and hyperthermia for radiation‐associated sarcoma

Jong, M.A.A. de; Oldenborg, S.; Oei, S.B.; Griesdoorn, V.; Kolff, M.W.; Koning, Caro C.E.; Tienhoven, Geertjan van

doi:10.1002/cncr.26252

Cited by 50 publications

(36 citation statements)

References 45 publications

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“…However, complete RAAS response rates using radiotherapy with hyperthermia have been reported [23, 24]. Additionally, a recent study observed local recurrence in only 1 of 13 patients who received radiation for their RAAS versus 10 of 29 who underwent surgery alone.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes in Patients with Radiation-Associated Angiosarcomas of the Breast Following Surgery and Radiotherapy for Breast Cancer

et al. 2012

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Background Radiation-associated angiosarcoma (RAAS) is a devastating disease occasionally observed in breast cancer patients treated with radiation. Due to its rarity, our knowledge—of disease risk factors, epidemiology, treatment, and outcome—is extremely limited. Therefore, we sought to identify clinicopathologic factors associated with local and distant recurrence, and disease-specific survival (DSS). Methods Radiation-associated angiosarcoma was defined as pathologically confirmed breast or chest wall angiosarcoma arising within a previously irradiated field. A comprehensive search of our institutional tumor registry (1/1/93 through 2/28/11) was used to identify patients (n=95 females); patient, original tumor, RAAS treatment, and outcome variables were retrospectively retrieved and assembled into a database. Results The median follow-up for all RAAS patients was 10.3 years (range, 2.4 – 31.8 years). The latency period following radiation exposure ranged from 1.4 to 26 years (median = 7 years). One- and five-year DSS rates were 93.5% and 62.6%, respectively. Reduced risk of local recurrence was observed in patients who received chemotherapy (P = 0.0003). In multivariable analysis, size was found to be an independent predictor of adverse outcome (P = 0.015). Discussion Our study demonstrates that RAAS exhibits high recurrence rates. It also highlights the need for well-designed multicenter clinical trials to inform the true utility of chemotherapy in this disease.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes in Patients with Radiation-Associated Angiosarcomas of the Breast Following Surgery and Radiotherapy for Breast Cancer

et al. 2012

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“…In another study, 16 patients received irradiation with concurrent HT for the treatment of radiation-associated sarcomas (predominantly angiosarcoma) showing a total response rate of 75%. Toxicity was mild except one grade 4 adverse event (117). First clinical results show general feasibility of applying RTHT to sarcoma treatment.…”

Section: Clinical Evidence Of Combined Thermoradiotherapymentioning

confidence: 99%

Integrating Hyperthermia into Modern Radiation Oncology: What Evidence Is Necessary?

2017

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Hyperthermia (HT) is one of the hot topics that have been discussed over decades. However, it never made its way into primetime. The basic biological rationale of heat to enhance the effect of radiation, chemotherapeutic agents, and immunotherapy is evident. Preclinical work has confirmed this effect. HT may trigger changes in perfusion and oxygenation as well as inhibition of DNA repair mechanisms. Moreover, there is evidence for immune stimulation and the induction of systemic immune responses. Despite the increasing number of solid clinical studies, only few centers have included this adjuvant treatment into their repertoire. Over the years, abundant prospective and randomized clinical data have emerged demonstrating a clear benefit of combined HT and radiotherapy for multiple entities such as superficial breast cancer recurrences, cervix carcinoma, or cancers of the head and neck. Regarding less investigated indications, the existing data are promising and more clinical trials are currently recruiting patients. How do we proceed from here? Preclinical evidence is present. Multiple indications benefit from additional HT in the clinical setting. This article summarizes the present evidence and develops ideas for future research.

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“…Although, its application was quite restricted at the beginning (probably due to earlier technical difficulties in delivering heat on the tumor site) its beneficial effects were evident from early studies [106,107]. A great number of randomized phase II and III clinical trials utilizing hyperthermia have outlined its contribution in potentiating the efficiency of irradiation in treating breast [108], cervical [109], lung [110], head and neck [111], melanoma [112], gastrointestinal [113] and sarcoma cancers [114]. Furthermore, hyperthermia combined with several chemotherapeutic agents has been the subject of numerous phase II and III clinical trials.…”

Section: Hyperthermia In Clinical Practicementioning

confidence: 99%

Effects of hyperthermia as a mitigation strategy in DNA damage-based cancer therapies

Mantso

Goussetis

Franco

et al. 2016

Seminars in Cancer Biology

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Utilization of thermal therapy (hyperthermia) is defined as the application of exogenous heat induction and represents a concept that is far from new as it goes back to ancient times when heat was used for treating various diseases, including malignancies. Such therapeutic strategy has gained even more popularity (over the last few decades) since various studies have shed light into understanding hyperthermia's underlying molecular mechanism(s) of action. In general, hyperthermia is applied as complementary (adjuvant) means in therapeutic protocols combining chemotherapy and/or irradiation both of which can induce irreversible cellular DNA damage. Furthermore, according to a number of in vitro, in vivo and clinical studies, hyperthermia has been shown to enhance the beneficial effects of DNA targeting therapeutic strategies by interfering with DNA repair response cascades. Therefore, the continuously growing evidence supporting hyperthermia's beneficial role in cancer treatment can also encourage its application as a DNA repair mitigation strategy. In this review article, we aim to provide detailed information on how hyperthermia acts on DNA damage and repair pathways and thus potentially contributing to various adjuvant therapeutic protocols relevant to more efficient cancer treatment strategies.

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Reirradiation and hyperthermia for radiation‐associated sarcoma

Cited by 50 publications

References 45 publications

Long-Term Outcomes in Patients with Radiation-Associated Angiosarcomas of the Breast Following Surgery and Radiotherapy for Breast Cancer

Long-Term Outcomes in Patients with Radiation-Associated Angiosarcomas of the Breast Following Surgery and Radiotherapy for Breast Cancer

Integrating Hyperthermia into Modern Radiation Oncology: What Evidence Is Necessary?

Effects of hyperthermia as a mitigation strategy in DNA damage-based cancer therapies

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