PATCHWORK FIELDS IN THERMORADIOTHERAPY FOR EXTENSIVE CHEST-WALL RECURRENCES OF BREAST-CARCINOMA

Chest wall lesions of advanced breast carcinoma in 23 patients were tr eated with thermoradiotherapy with clinical intent between January 198 7 and March 1992. Treatment consisted of external 915 MHz microwave hy perthermia with commercially available applicators and radiation thera py to doses between 32-58 Gy. Twenty-three large, diffuse lesions were treated with multiple field patchwork hyperthermia. All lesions were diffuse with or without multiple nodules greater than or equal to 3 cm depth. All lesions had failed previous therapy. The mean number of hy perthermia fields per patient was 3.2+/-0.4 (range of 2-7). The comple te response rate was 91% in this group of extensive, diffuse lesions t reated by the patchwork technique. Mean total radiation dose administe red concurrently with multiple field patchwork hyperthermia was 42+/-1 Gy. The recurrence rate was 5%. The mean survival in patients who had a complete response was 9.0+/-1.3 months. The reduced survival among patchwork treated patients was due to the extensive tumor burden exist ing outside of the treated fields in these patients. The skin reaction s were minor, causing minimal discomfort. There was no evidence of inc reased thermal damage to skin, or of tumor recurrence at junctions of hyperthermia field overlap. It is concluded that extensive, diffuse le sions of chest wall recurrence of advanced carcinoma of the breast can be treated effectively with multiple field patchwork thermotherapy.