Acute and late toxicities of adjuvant hypofractionated radiotherapy with weekly concomitant boost for women with early breast cancer

Gaber, Mohmed Soliman; Ali, Ali Mohammed; Hassan, Emad El Din Nabil; Hussein, Asmaa

doi:10.21608/smj.2019.43391

Acute and late toxicities of adjuvant hypofractionated radiotherapy with weekly concomitant boost for women with early breast cancer

Document Type : Original Article

Authors

¹ Department of Clinical Oncology , Faculty of Medicine, Sohag University.

² Department of Clincal Oncology and Nuclear Medicine, Faculty of Medicine, Sohag University.

³ Department of Clinical Oncology, Faculty of Medicine, Sohag University.

10.21608/smj.2019.43391

Abstract

The aim of this investigation was to evaluate the feasibility of a shortened whole breast irradiation schedule with a concomitant boost delivered to the tumor bed once a-week in patients with early breast cancer submitted to conservative surgery. Methods: This study included 48 female patients with early breast cancer who underwent breast conservative surgery. There were two arm of radiation, hypofractionated radiotherapy with concomitant boost (group A) - hypofractionated radiotherapy with sequential boost (group B).
Results: Acute skin toxicity grade 1 (dry desquamation) was (41.67%) in concomitant boost arm and (25.00%) sequential boost arm. late skin toxicity ,grade 0 was (72.73%) in concomitant boost arm and (54.55%) in sequential boost arm and grade 1 was (9.09%) in concomitant boost arm and (31.82%) in sequential boost arm and grade 2 was (18.19) in concomitant boost arm and (13.55%) in sequential boost arm, grade 3 late lung toxicity was (4.17%) in concomitant boost arm and (12.50%) in sequential boost arm, cardiac toxicity in concomitant boost arm (8.33%) and sequential boost arm (16.67%).The ipsilateral lymphedema after 24 months of follow up G2 (4.55%) in concomitant boost arm G3 (4.55%) in in sequential boost arm.
Conclusion: A shortened whole breast irradiation schedule with a weekly concomitant boost may be an alternative option with acceptable toxicity and excellent cosmesis.

Main Subjects

Oncology and Nuclear Medicine.

References

1-Freedman GM, Andersson PR, Goldstein LJ, Ma CM, Li J, Swaby RF, Litwin S, Watkins-Bruner D, Sigurdson ER, Morrow M: Four-week course of radiation for breast cancer using hypofractionated intensity modulated radiation therapy with an incorporated boost. Int J Radiat Oncol Biol Phys 2007, 68(2):347-53.

2-Shelley W, Brundage M, Hayter C, Paszat L, Zhou S, Mackillop W: A shorter fractionation schedule for postlumpectomy breast cancer patients. Int J Radiat Oncol Biol Phys 2000, 47(5):1219-28.

3-Guenzi M, Vagge S, AzinwN, et al: A biologically competitive 21 days hypofractionation scheme with weekly concomitant boost in breast cancer radiotherapy feasibility acute sub-acute and short term late effects Radiat Oncol. 2010; 5: 111

4-Corvo R, Ricchetti F, Doino D, et al: Adjuvant hypo fractionated radiotherapy with weekly concomitant boost for women with early breast cancer: the clinical experience at GenoaUniversity. Anticancer Res2010; 30: 4749–4753

5-Shahid A, Athar MA, Asghar S, et al: Post mastectomy adjuvant radiotherapy in breast cancer: a comparision of three hypofractionated protocols. J Pak Med Assoc. 2009; 59(5):282-7.

6-El-Hadaad, H.A., Wahba, H.A., Elnahas, W. and Roshdy, S. (2016) Concomitant Boost Radiotherapyafter Conservative Breast Surgery in Early Breast Cancer. Advances in Breast Cancer Research, 5, 97-102.

7-Disipio T, Rye S, and Newman B: Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 2013 ;14(6):500-15.