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@ARTICLE{Zwicker:275616,
      author       = {F. Zwicker$^*$ and R. Klepper and H. Hauswald$^*$ and S.
                      Hoefel and L. Raether and P. E. Huber$^*$ and J. Debus$^*$
                      and M. Schempp},
      title        = {{H}elical {T}omotherapy of {L}ymph {N}ode-negative
                      {E}arly-stage {B}reast {C}ancer {A}fter {B}reast-conserving
                      {S}urgery: {L}ong-term {R}esults.},
      journal      = {Anticancer research},
      volume       = {43},
      number       = {5},
      issn         = {0250-7005},
      address      = {Attiki},
      reportid     = {DKFZ-2023-00822},
      pages        = {2041 - 2053},
      year         = {2023},
      note         = {#EA:E055#},
      abstract     = {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.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.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.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.},
      keywords     = {Breast cancer (Other) / helical IMRT (Other) / long-term
                      results (Other) / lymph node negative (Other) / lymphedema
                      (Other) / radiotherapy (Other) / secondary malignoma (Other)
                      / tomotherapy (Other)},
      cin          = {E055},
      ddc          = {610},
      cid          = {I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37097694},
      doi          = {10.21873/anticanres.16365},
      url          = {https://inrepo02.dkfz.de/record/275616},
}