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Comparison of result and outcome of conventional and hypofractionated radiotherapy in post-operative breast cancer patients

Pabitra Das, Tapas Kumar Das, Arpan Jana, Phalguni Gupta, Poulami Gupta, Sunita Das.




Abstract
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Background: Radiotherapy following surgery is to minimize the risk of disease recurrence in carcinoma breast. Conventional fractionated radiotherapy is associated with lengthy hospitalization and longer waiting lists. However, hypofractionated radiotherapy had been studied in the western countries and associated with less overall treatment time, more convenient for patients and health-care providers, but there are no enough data in eastern India.

Aims and Objectives: The present study was planned to compare the locoregional control and toxicity of conventional fractionated radiotherapy with hypofractionated radiotherapy in post-mastectomy early and locally advanced carcinoma breast patients of eastern India.

Materials and Methods: The study was conducted on 108 patients with histologically proven invasive ductal carcinoma breast, and modified radical mastectomy was done. 53 patients in control group received 50 Gy in 25 fractions in 5 weeks and 55 patients in study group received hypofractionated radiotherapy 42.56 Gy in 16 fractions in 3.1 weeks.

Results: Median age of the patient in control group was 50 years and study group was 48 years. The incidence of Grade 1 acute skin toxicity was 75.4% (40/53) and 76.3% (42/55) in patients of control group and study group, respectively. Late skin toxicity grade 1 in control group and study group was 73.6% (39/53) and 72.7% (40/55), respectively. At the end of follow-up of 2 years, the incidence of locoregional disease control in control group and study group was 90.5% (48/53) and 89% (49/55), respectively.

Conclusion: In our study, both control group and study group showed almost similar results in terms of locoregional disease control and toxicities. Hence, hypofractionation radiotherapy is not inferior to conventional fractionation radiotherapy in terms of disease control and late toxicities.

Key words: Breast Cancer; Hypofractionation; Toxicity






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