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@ARTICLE{Zwicker:300741,
      author       = {F. Zwicker$^*$ and L.-P. Raether and R. Klepper and H.
                      Hauswald$^*$ and S. Hoefel and P. Huber$^*$ and J. Debus$^*$
                      and M. Schempp},
      title        = {{L}ong-term {O}utcomes of {H}elical {T}omotherapy in
                      {L}ymph {N}ode-positive {B}reast {C}ancer {F}ollowing
                      {B}reast-conserving {S}urgery.},
      journal      = {Anticancer research},
      volume       = {45},
      number       = {5},
      issn         = {0250-7005},
      address      = {Kapandriti, Attiki, Greece},
      publisher    = {International Institute of Anticancer Research},
      reportid     = {DKFZ-2025-00901},
      pages        = {2025 - 2040},
      year         = {2025},
      note         = {#EA:E055#},
      abstract     = {Adjuvant radiotherapy is an integral component of the
                      interdisciplinary curative treatment of lymph node-positive
                      breast cancer. We investigated long-term clinical outcomes
                      of helical tomotherapy following breast-conserving
                      surgery.This single-center analysis included 80 female
                      patients with breast cancer stages T1-T4 and lymph node
                      metastasis (N1-N3) who underwent breast-conserving surgery,
                      sentinel node biopsy, and/or axillary lymph node dissection.
                      Patients received adjuvant fractionated radiation therapy to
                      the whole breast and regional lymph node areas using helical
                      tomotherapy. Boost irradiation was delivered sequentially or
                      through the simultaneous integrated boost technique. Local
                      control (LC), metastasis, survival, toxicity, and secondary
                      malignancy rates were retrospectively analyzed.The mean
                      follow-up duration was 75 months. The 5- and 8-year overall
                      survival rates were $89.4\%$ and $87.0\%,$ respectively. LC
                      rates at 5- and 8-year were $98.7\%,$ and metastasis-free
                      survival rates were $91.2\%$ and $85.2\%,$ respectively.
                      Acute erythema occurred in $70\%$ (Grades 1-2) and $26\%$
                      (Grade 3) of patients. Ipsilateral arm lymphedema of Grade 1
                      and Grade 2 developed in $10\%$ and $1.3\%$ of the treated
                      patients, respectively. Acute or late toxicities exceeding
                      Grade 3 were not observed.Helical tomotherapy showed
                      excellent long-term results and low toxicity rates as
                      adjuvant radiotherapy in patients with lymph node-positive
                      breast cancer. The incidence of secondary malignancies was
                      relatively low and corresponded to the preexisting records
                      on radiation therapy. Broader clinical implementation of
                      helical tomotherapy could benefit patients.},
      keywords     = {Humans / Female / Breast Neoplasms: radiotherapy / Breast
                      Neoplasms: pathology / Breast Neoplasms: surgery / Breast
                      Neoplasms: mortality / Middle Aged / Mastectomy, Segmental /
                      Adult / Aged / Lymphatic Metastasis: radiotherapy /
                      Radiotherapy, Intensity-Modulated: methods / Radiotherapy,
                      Intensity-Modulated: adverse effects / Radiotherapy,
                      Adjuvant: adverse effects / Radiotherapy, Adjuvant: methods
                      / Retrospective Studies / Treatment Outcome / Lymph Nodes:
                      pathology / Sentinel Lymph Node Biopsy / Lymph Node Excision
                      / Helical tomotherapy (Other) / adjuvant radiotherapy
                      (Other) / lymph node-positive breast cancer (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:40295057},
      doi          = {10.21873/anticanres.17577},
      url          = {https://inrepo02.dkfz.de/record/300741},
}