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International Journal of Oncology Research

Vol. 4, Issue 1, Part A (2024)

A comparative study of conventional and hypofractionated radiotherapy in postmastectomy breast cancer patients

Author(s):

Dina Gamal Hammad, Mohamed Abdo El-Shebeiny, Nesreen Mohamed Sabry and Marwa Aboelsaoud Taha

Abstract:

The aim of this work is: 1. Statistically comparative analysis between female BC patients treated with postmastectomy CR or HR as regard: Patients and tumor characteristics, Local recurrence and distant metastasis, Overall survival, Treatment toxicity. 2. Statistical analysis of the different prognostic factors affecting the overall survival (OS) and disease free survival (DFS) between the two treated groups.
Patients and Methods: This is a retrospective phase II single center study was carried out to compare five hundreds female BC patients presented and treated with postmastectomy CFRT or HFRT at Clinical Oncology Department Tanta University hospital during the period between January 2016 to December 2020 with a minimum follow up period of one year. The study was approved by the Ethical Standards of the Ethics Committee of Faculty of Medicine, Tanta University, Egypt.
Results: The mean age of the all patients was 47.64 ± 12.35 and the median age was 51 years. 62.4% of patients aged ≤55 years and 37.6% of patients aged > 55 years. About half (50.4%) of the patients presented with ECOG PS o. 40.6% of the patients were premenopausal and 59.4% were postmenopausal. The mean total RT dose in the CFRT and HFRT groups were 3987.39±1070.43 and 3764.88±758.38 respectively (p=0.001). The mean dose/fraction in the CFRT and HFRT groups were 199.17±4.00 and 265.03±0.25 respectively (p=0.001). The mean number of fractions in the CFRT and HFRT groups were 19.98±5.27 and 14.20±2.86 respectively (p=0.001). Acute dermatitis had occurred in 50.2% of patients in the group versus 52.1% in the HFRT group (p=0.651). Chronic dermatitis had occurred in 5.8% of patients in the CFRT group versus 6.2% in the HFRT group (p=0.862). Locoregional failure had occurred in 7% of patients in CFRT group and 5% of patients in HFRT group. Overall locoregional failure had occurred in 6% of all patients. Chest wall was the most common site of locoregional failure in all patients (2.2%) followed with axilla and chest wall (1.4%) and axilla alone (1%). Distant failure had occurred in 40.7% of patients in CFRT and in 34.7% of patients in HFRT. Overall distant failure had occurred in 37.6 of all patients. Bone metastases was the most common site of distant failure in all patients (17.8%).
Conclusion: Post-mastectomy radiotherapy remains a subject of ongoing extensive investigation; nonetheless, recent controlled trials provide a rationale for the systematic utilization of Hypofractionated Radiotherapy (HFRH) as an adjunct treatment for breast cancer in females. The advantages of hypofractionated radiation therapy include shorter completion time, leading to decreased interruptions unrelated to treatment, ultimately enhancing treatment efficacy and patient adherence. This approach can facilitate the treatment of a greater number of breast cancer patients within a calendar year, thereby reducing waiting lists, increasing turnover, and lowering treatment costs. Our research findings indicate that HFRH yields outcomes comparable to Conventional Fractionated Radiotherapy (CFRT) without demonstrating inferior Overall Survival (OS), Long-Term Complications (LTC), Disease Metastasis (DM) rates, or heightened adverse effects. Therefore, hypofractionated radiation therapy can be recommended as a secure and efficient substitute for CFRT in post-mastectomy radiotherapy targeting the chest wall and lymph nodes. However, these outcomes necessitate assessment through extensive prospective multicenter randomized trials with prolonged follow-up periods and larger sample sizes to establish Hypofractionation (HF) as a viable alternative to Conventional Fractionation (CF) in breast cancer management.
 

Pages: 37-43  |  70 Views  37 Downloads


International Journal of Oncology Research
How to cite this article:
Dina Gamal Hammad, Mohamed Abdo El-Shebeiny, Nesreen Mohamed Sabry and Marwa Aboelsaoud Taha. A comparative study of conventional and hypofractionated radiotherapy in postmastectomy breast cancer patients. Int. J. Oncol. Res. 2024;4(1):37-43. DOI: 10.33545/2664665X.2024.v4.i1a.17
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