Hypofractionated radiotherapy in breast cancer: Is it safe?
Journal Title: Harsukh Educational Charitable Society International Journal of Community Health and Medical Research - Year 2018, Vol 4, Issue 4
Abstract
Introduction: Radiation therapy has gained an established role in the treatment of breast cancer either as chest wall irradiation after modified radical mastectomy, or as whole breast irradiation after a breast conserving surgery (BCS). For patients with resectable tumour undergoing mastectomy, radiation therapy to chest wall and regional lymph nodes to a total dose of 5000-6000 cGy is usually employed. The aim of the present study was to assess a hypofractionated RT regimen of 42.5Gy/16#/3wks versus the conventional RT regimen of 50Gy/25#/5wks in post mastectomy patients of breast cancer in our institute and to compare the acute and late toxicities as well as effectiveness with conventional method. Materials and methods: Thirty women of breast cancer, who were post mastectomy were assigned to receive 42.5 Gy/ 16#/3wks and for comparison, a group of 30 patients with similar characteristics were treated with conventional fractionation and received 50 Gy/25#/5 wks. Results: The grade 2 and 3 skin toxicity in group A was 13.33% and 10% respectively. Grade 4 toxicity was not seen. group B had grade 2 in 6.7% patients. No patient had grade 3 and 4 toxicity in group B. Grade 1 lymphoedema was seen in 53%, grade 2 in 30% and grade 3 in 6.7% patients in group A and 53%, 20% and 16.7% in group B respectively. On HRCT, chest for lung toxicity, group A had ground glass appearance in 3.4% patients, pleural thickness in 10.4% and septal lines, linear opacifications and subpleural opacities were seen in 58.6% patients. In group B, it was 6.7%, 13.3% and 36.7% respectively. Conclusion: The hypofractionated protocol can be safely used as the toxicities and effectiveness are comparable to the conventional radiotherapy in post mastectomy breast cancer patients. Hypofractionated radiotherapy was cost effective and more convenient to the patients as the use of 16 fractions (instead of 25), saves 900 treatment sessions per 100 patients (2500-1600=900). This corresponds to an additional number of 56 (900:16) patients that could be treated by the same number of fractions.
Authors and Affiliations
Neeru Bedi, Hanuman Prasad Yadav, RPS Banipal, Simmi Agarwal, Yashna Gupta
Keywords
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