Evaluation of the efficacy and the safety of a hypofractionated radiotherapy course with weekly concomitant boost for breast cancer patients treated with conservative breast surgery | ||
| SECI Oncology Journal | ||
| Article 2, Volume 4, Issue 2, April 2016, Pages 28-34 PDF (189.6 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/secioj.2016.5681 | ||
| Abstract | ||
| Background: Radiation therapy after breast conserving surgery is a standard part of treatment for invasive breast cancer. Based on radiobiological models, it was found that shorter hypofractiontaed radiation schedules had equivalent local control to standard radiation therapy. Radiation boost to the tumor bed was evident to be associated with significant improvement in local control. Methods: This study included 50 female patients with operable invasive stage I-II breast cancer. Patients underwent microscopic wide local excision of the primary tumor with axillary lymph node dissection. They received adjuvant radiotherapy with 42.5 Gy total dose in 16 fractions for whole breast and additional boost dose to tumor bed of 1Gy once weekly in three consecutive fractions for total boost dose of 3 Gy. Results: Median age was 47 years: 60% of patients was the most common one. Invasive ductal carcinoma was reported in 94% and hormone receptors were positive in 70% of patients. After median follow-up of 29 months, 2 year DFS was 94%, all patients were alive and ipsilateral local recurrence was reported in 2% only. Grade III-IV radiation toxicities were not observed. 36% and 12% had Grade I and II acute skin toxicity respectively. At 12 months, grades (I-II) were reported as (20%-8%) telangiectasia, (18%-2%) hyperpigmentation, (18%-4%) subcutaneous fibrosis, and (14%-8%) lymphedema respectively while at 24 months grade II only reported as 2% lymphedema. Acute radiation pneumonitis reported as 8%grade I and 4% grade II while chronic pulmonary fibrosis reported as 6% grade I and 2% grade II. Only 2 patients (7.6%) developed more than 10% drop in the left ventricular ejection fraction (LVEF). Conclusion: The results of our study suggest there are no increased acute or late toxicities with comparable DFS and local control rates affiliated with the hypofractionated adjuvant breast radiotherapy schedule with once weekly concomitant boost as prescribed. Large randomized trials and long-term follow-up are needed to confirm these favorable findings | ||
| Keywords | ||
| breast cancer; Hypofractionated irradiation; Concurrent boost; toxicity | ||
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