Postmastectomy hypofractionation comparison with conventional radiotherapy in breast cancer patients: A prospective study

Document Type : Original Article

Authors

1 Department of Clinical oncology, Faculty of Medicine, Sohag University, Sohag, Egypt.

2 Department of Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt.

3 Department of Clinical Oncology ,FacultyofMedicine,Sohag University.

Abstract

Background: Postmastectomy radiotherapy reduces loco-regional recurrence among womenwith operable breast cancer and improves survival for up to 10 years.
Objectives: Conventional fractionated radiotherapy (CF) has been limited by patient’scompliance, travelling, unplanned interruption and others. Hypofractionated (HF) schedule wouldbe more appealing and convenient for both patients and radiotherapists. We prospectively testedfor OS, DFS, locoregional control, and treatment related toxicities, in patients treated with CFand HF schedules.
Methods: 47 patients suffering from cancer breast stage T2-4, any N, underwent surgery andreceived adjuvant systemic and radiation therapies. These patients were scheduled for adjuvantradiotherapy and randomly divided into two groups; CF (n = 162), and HF (n = 181).The logrank test examined differences in OAS and DFS rates. Data of radiation toxicities, and diseaserelapse in both CF and HF groups were compared using Chi-square test.
Findings: The median follow up was 34 months (range: 13 – 53 months). Four-year OAS ratesfor the both groups were 98 % with 100% for CF and 96% for HF group, and with no significantdifference (P value= 0.37). The 4 year disease free survival rate for both were 87% with 81% and 92% for CF and HF respectively (p-value= 0.47) and HR= 0.52 (0.09-2.13). As regard treatment related toxicity, 3 patients (12%) of HF group had toxicity compared with 1 patient (4.5%) in CF, yet, not statistically significant.
Interpretation: these data showed that HF 42 Gy radiotherapy in 16 fractions was not inferior,safe and comparable to CF in terms of OAS, loco-regional tumor control and toxicities. These results need to be tested in large scale multicenter randomized control trials.

Keywords

References

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