Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5
DOI: 10.33266/1024-6177-2022-67-5-64-68
V.V. Velikaya, Zh.A. Startseva, V.A. Lisin, V.E. Goldberg,
N.O. Popova
ADJUVANT NEUTRON THERAPY IN COMBINED MODALITY TREATMENT OF PATIENTS WITH PRIMARY-METASTATIC BREAST CANCER
Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia
Contact person: V.V. Velikaya, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To present long-term results adjuvant neutron therapy in combined modality treatment of patients with primary-metastatic breast cancer.
Material and methods: The studied included 53 patients with stage T2-4N1-3M1 breast cancer, who underwent multimodality treatment: neoadjuvant chemotherapy (NACT) and adjuvant chemotherapy (ACT) according to CMF, CAF/FAC schemes, antiestrogen therapy
(if indicated), radical mastectomy (RM) and radiotherapy using different types of ionizing radiation, from 2007 to 2018. All patients were divided into two groups. Group I patients (n = 23) underwent neutron therapy delivered to the anterior chest and group II patients
(n = 30) received photon therapy.
Results: The 6-year disease-free survival rate was 93.7 ± 6.1 % in patients who received adjuvant neutron therapy and 67.8 ± 7.6 % in patients who received photon therapy (p = 0.047). The overall 6-year survival rates in groups I and II were 68.9 ± 7.8 % and 45.9 ± 6.9, respectively (p = 0.36). Neutron therapy was well tolerated by all breast cancer patients.
Conclusion: In patients with stage T2-4N1-3M1 breast cancer neutron therapy as a dense ionizing radiation is more effective due to its biological characteristics. Radical surgery combined with chemotherapy is known to improve survival of breast cancer patients
Keywords: metastatic breast cancer, combined modality treatment, radical mastectomy, radiation therapy, neutron therapy, local recurrence, radiation-induced injuries, survival
For citation: Velikaya VV, Startseva ZhA, Lisin VA, Goldberg VE, Popova NO. Adjuvant Neutron Therapy in Combined Modality Treatment of Patients with Primary-Metastatic Breast Cancer. Medical Radiology and Radiation Safety. 2022;67(5):64–68. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-64-68
References
1. Kaprin A.D., Starinskiy V.V., Petrova G.V. Zlokachestvennyye Novoobrazovaniya v Rossii v 2016 g. (Zabolevayemost i Smertnost) = Malignant Neoplasms in Russia in 2016 (Morbidity and Mortality). Moscow Publ., 2018. 250 p. (In Russ.).
2. Tretyak I.Yu., Demidchik Yu.Ye., Kostyuk S.A. Metastatic Breast Cancer: Clinical and Morphological Analysis. Onkologicheskiy Zhurnal = Oncological Journal. 2015;9;2:37-48 (In Russ.).
3. Cardoso F., Senkus-Konefka E., Fallowfield L., et al. Locally Recurrent or Metastatic Breast Cancer: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up. Ann Oncol. 2010;21;5:15-19.
4. Bozhok A.A., Topuzov E.E., Zakiryakhodzhayev A.D., et al. Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM). Opukholi Zhenskoy Reproduktivnoy Sistemy = Tumors of Female Reproductive System. 2016;12;4:17-24 (In Russ.).
5. Kolyadina I.V. Treatment of Patients with Local and Locoregional Breast Cancer Recurrence. Materialy Bolshoy Konferentsii Russco po Raku Molochnoy Zhelezy = Materials of the RUSSCO Conference on Breast Cancer. Moscow Publ., 2015. P.107-111 (In Russ.).
6. Startseva Zh.A., Simonov K.A., Slonimskaya Ye.M. Selection of the Optimal Volume of Irradiation in Breast Cancer Patients in Accordance with Significant Predictors. Voprosy Onkologii = Problems in Oncology. 2015;61;5:778-781 (In Russ.).
7. Pagani O., Senkus E., Wood W., et al. International Guidelines for Management of Metastatic Breast Cancer: Can Metastatic Breast Cancer Be Cured? J. Natl. Cancer Inst. 2010;102;7:456–463.
8. Bozhok A.A., Topuzov E.E., Semiglazov V.F., et al. Efficacy of Surgical Treatment for Metastatic Breast Cancer. Uralskiy Meditsinskiy Zhurnal = Ural Medical Journal. 2014;2:41-47 (In Russ.).
9. Mardynskiy Yu.S., Gulidov I.A., Aminov G.G., et al. Mixed (Photon-Neutron) Therapy in Complex Treatment for Locally Advanced Breast Cancer. Voprosy Onkologii = Problems in Oncology. 2014;60;4:489-492 (In Russ.).
10. Kandakova Ye.Yu., Vazhenin A.V., Kuznetsova A.I., et al. Results of the Combined Photon-Neutron Therapy in the Conditions of Escalation of a Dose of Neutrons Generally a Course of the Combined Photon-Neutron Therapy. Vestnik Rossiyskogo Nauchnogo Tsentra Rentgenoradiologii MZ Rossii. 2014;14-4:7 (In Russ.).
11. Bobkova G.G., Vazhenin A.V., Kandakova Ye.Yu., et al. Results of Concomitant Photon-Neutron Therapy in the Palliative Treatment of Metastatic Brain Tumors According to the Data of the Chelyabinsk Regional Clinical Oncology Dispensary. Opukholi Golovy i Shei = Head and Neck Tumors (HNT). 2014. № 1. P.38-42 (In Russ.).
12. Choynzonov Ye.L., Musabayeva L.I., Avdeyenko M.V., Gribova O.V. Combined Modality Treatment Including Radiation Therapy for Salivary Gland Cancer. Rossiyskiy Onkologicheskiy Zhurnal = Russian Journal of Oncology. 2010;4:25-28
(In Russ.).
13. Startseva Zh.A. Long-Term Treatment Results of Patients with Locally Advanced Breast Cancer Treated with 6.3 MeV Fast Neutrons. Aktualnyye Problemy Gumanitarnykh i Yestestvennykh Nauk. 2015;3-2:223-226. (In Russ.).
14. Musabaeva L.I., Startseva Zh.A., Gribova O.V., et al. Novel Technologies and Theoretical Models in Radiation Therapy of Cancer Patients Using 6.3 MEV Fast Neutrons Produced by U-120 Cyclotron. AIP Conference Proceedings. 2016;1760;1:020050.
15. Velikaya V.V., Startseva Zh.A., Lisin V.A., et al. Late Effects of Combined Modality Treatment with Adjuvant Neutron Therapy for Locally Advanced Breast Cancer. Radiatsiya i Risk = Radiation and Risk. 2018;27;1:107-114 (In Russ.).
16. Velikaya V.V., Musabayeva L.I., Startseva Zh.A., Lisin V.A. Fast Neutrons of 6.3 MeV in Complex Treatment of Patients with Breast Cancer Local Recurrences. Voprosy Onkologii = Problems in Oncology. 2015;61;4:583-585 (In Russ.).
17. Choynzonov YE.L., Lisin V.A., Gribova O.V., et al. Methodological Approaches to Prevention of Radiation-Induced Skin Reactions in Neutron-Photon Therapy for Malignant Neoplasms. Sibirskiy Onkologicheskiy Zhurnal = Siberian Journal of Oncology. 2019;18;2:44-51. https://doi.org/10.21294/1814-4861-2019-18-2-44-51 (In Russ.).
18. Velikaya V.V., Gribova O.V., Musabayeva L.I., et al. Ozone Therapy for Radiation Reactions and Skin Lesions after Neutron Therapy in Patients with Malignant Tumors. Voprosy Onkologii = Problems in Oncology. 2015;61;4:571-574
(In Russ.).
19. Kucherova T.Ya., Velikaya V.V., Gribova O.V., et al. Physical Therapy Methods in the Treatment and Rehabilitation of Cancer Patients. AIP Conference Proceedings. 2016;1760;1:020038.
20. Lisin V.A. TDF-Model for Fast Neutron Radiation Therapy of Malignant Tumors. Meditsinskaya Radiologiya. 1988;9: 9-12 (In Russ.).
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.06.2022. Accepted for publication: 25.08.2022.