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@ARTICLE{Hoeltgen:275358,
      author       = {L. Hoeltgen and E. Meixner and P. Hoegen$^*$ and E.
                      Sandrini and F. Weykamp$^*$ and T. Forster and M. Vinsensia
                      and K. Lang and L. König and N. Arians and C. Fremd and L.
                      L. Michel and K. Smetanay and A. Schneeweiss and M.
                      Wallwiener and J. Debus$^*$ and J. Hörner-Rieber$^*$},
      title        = {{P}alliative {R}adiotherapy for {S}ymptomatic {L}ocally
                      {A}dvanced {B}reast {C}ancer.},
      journal      = {Technology in cancer research $\&$ treatment},
      volume       = {22},
      issn         = {1533-0346},
      address      = {Thousand Oaks, CA},
      publisher    = {Sage Publishing},
      reportid     = {DKFZ-2023-00727},
      pages        = {153303382311645 -},
      year         = {2023},
      note         = {#LA:E050#},
      abstract     = {Objective: Women with locally advanced breast cancer (LABC)
                      or inoperable local recurrence often suffer from a
                      significantly reduced quality of life (QOL) due to local
                      tumor-associated pain, bleeding, exulceration, or malodorous
                      discharge. We aimed to further investigate the benefit of
                      radiotherapy (RT) for symptom relief while weighing the
                      side-effects. Materials and methods: Patients who received
                      symptom-oriented RT for palliative therapy of their LABC or
                      local recurrence in the Department of Radiation Oncology at
                      Heidelberg University Hospital between 2012 and 2021 were
                      recorded. Clinical, pathological, and therapeutic data were
                      collected and the oncological and symptomatic responses as
                      well as therapy-associated toxicities were analyzed.
                      Results: We retrospectively identified 26 consecutive women
                      who received palliative RT with a median total dose of 39 Gy
                      or single dose of 3 Gy in 13 fractions due to (impending)
                      exulceration, pain, local hemorrhage, and/or vascular or
                      plexus compression. With a median follow-up of 6.5 months
                      after initiation of RT, overall survival at 6 and 12 months
                      was $60.0\%$ and $31.7\%,$ and local control was $75.0\%$
                      and $47.6\%,$ respectively. Radiation had to be discontinued
                      in 4 patients due to oncological clinical deterioration or
                      death. When completed as initially planned, symptom
                      improvement was achieved in $95\%$ and WHO level reduction
                      of analgesics in $28.6\%$ of patients. In $36\%$ $(16\%)$ of
                      patients, local RT had already been indicated >3 months (>6
                      months) before the actual start of RT, but was delayed or
                      not initiated among others in favor of drug alternatives or
                      systemic therapies. RT-associated toxicities included only
                      low-grade side-effects (CTCAE I°-II°) with predominantly
                      skin erythema and fatigue even in the context of re-RT.
                      Conclusion: Palliative RT in symptomatic LABC or
                      locoregional recurrence is an effective treatment option for
                      controlling local symptoms with only mild toxicity. It may
                      thus improve QOL and should be considered early in
                      palliative patient care management.},
      keywords     = {LABC (Other) / exulceration (Other) / hemorrhage (Other) /
                      pain (Other) / palliative care (Other) / radiation therapy
                      (Other)},
      cin          = {E050 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37038619},
      doi          = {10.1177/15330338231164537},
      url          = {https://inrepo02.dkfz.de/record/275358},
}