PT  - JOURNAL ARTICLE
AU  - ZWICKER, FELIX
AU  - KLEPPER, RUDOLF
AU  - HAUSWALD, HENRIK
AU  - HOEFEL, SEBASTIAN
AU  - RAETHER, LUIS
AU  - HUBER, PETER E.
AU  - DEBUS, JUERGEN
AU  - SCHEMPP, MICHAEL
TI  - Helical Tomotherapy of Lymph Node-negative Early-stage Breast Cancer After Breast-conserving Surgery: Long-term Results
AID  - 10.21873/anticanres.16365
DP  - 2023 May 01
TA  - Anticancer Research
PG  - 2041--2053
VI  - 43
IP  - 5
4099  - http://ar.iiarjournals.org/content/43/5/2041.short
4100  - http://ar.iiarjournals.org/content/43/5/2041.full
SO  - Anticancer Res2023 May 01; 43
AB  - 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.