Chicheł Adam, Burchardt Wojciech, Chyrek Artur J, Bielęda Grzegorz, Zwierzchowski Grzegorz, Stefaniak Patrycja, Malicki Julian
Department of Brachytherapy, Greater Poland Cancer Center, 61-866 Poznan, Poland.
Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland.
Life (Basel). 2022 Mar 30;12(4):512. doi: 10.3390/life12040512.
(1) Current breast-conserving therapy for breast cancer consists of a combination of many consecutive treatment modalities. The most crucial goal of postoperative treatment is to eradicate potentially relapse-forming residual cancerous cells within the tumor bed. To achieve this, the HDR brachytherapy boost standardly added to external beam radiotherapy was enhanced with an initial thermal boost. This study presents an original thermal boost technique developed in the clinic. (2) A detailed point-by-point description of thermal boost application is presented. Data on proper patient selection, microwave thermal boost planning, and interstitial hyperthermia treatment delivery are supported by relevant figures and schemes. (3) Out of 1134 breast cancer patients who were administered HDR brachytherapy boost in the tumor bed, 262 were also pre-heated interstitially without unexpected complications. The results are supported by two example cases of hyperthermia planning and delivery. (4) Additional breast cancer interstitial thermal boost preceding HDR brachytherapy boost as a part of combined treatment in a unique postoperative setting was feasible, well-tolerated, completed in a reasonable amount of time, and reproducible. A commercially available interstitial hyperthermia system fit and worked well with standard interstitial brachytherapy equipment.
(1) 当前乳腺癌保乳治疗由多种连续治疗方式组合而成。术后治疗的最关键目标是根除肿瘤床内潜在形成复发的残留癌细胞。为实现这一目标,在标准添加到外照射放疗的高剂量率近距离放疗增敏基础上,增加了初始热增敏。本研究介绍了一种在临床中开发的原创热增敏技术。(2) 给出了热增敏应用的详细逐点描述。关于合适患者选择、微波热增敏计划以及间质热疗治疗实施的数据由相关图表和示意图提供支持。(3) 在1134例接受肿瘤床高剂量率近距离放疗增敏的乳腺癌患者中,262例还接受了间质预热,未出现意外并发症。结果由热疗计划和实施的两个示例病例支持。(4) 在独特的术后环境中,作为联合治疗一部分,在高剂量率近距离放疗增敏之前进行额外的乳腺癌间质热增敏是可行的,耐受性良好,能在合理时间内完成且可重复。一种市售的间质热疗系统与标准间质近距离放疗设备适配且运行良好。