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03 August 2015 : Clinical Research  

Similar Outcomes of Standard Radiotherapy and Hypofractionated Radiotherapy Following Breast-Conserving Surgery

Hai-Ling HouABCDE, Yong-Chun SongBE, Rui-Ying LiA, Li ZhuBC, Lu-Jun ZhaoA, Zhi-Yong YuanE, Jin-Qiang YouE, Zhong-Jie ChenBC, Ping WangAE

DOI: 10.12659/MSM.893585

Med Sci Monit 2015; 21:2251-2256

Abstract

BACKGROUND: Adjuvant radiation therapy is commonly administered to breast cancer patients who received breast-conserving surgery. However, lengthy treatment times of standard radiotherapy pose certain challenges. Here, we performed a prospective controlled study comparing standard radiation to hypofractionated radiotherapy in terms of efficacy and outcome.

MATERIAL AND METHODS: Eighty breast cancer patients (tumor stage pT1-2N0-1M0) who had undergone breast-conservation surgery were randomly divided into 2 groups (40 patients/group). The experimental group received 43.2 Gy to the whole breast in 18 fractions for 24 days with a concomitant boost (50.4 Gy) to the tumor bed. The control group received 45 Gy to the whole breast in 25 fractions for 44 days with a boost to the tumor bed of 59 Gy. Survival, locoregional recurrence, adverse effects, and aesthetic results were all considered for analysis.

RESULTS: The following criteria were included as part of study follow-up: local control, survival, adverse skin reactions, cosmetic outcome, and hematological toxicity. At a median follow-up of 27 months (follow-up rate 100%), there were no statistical differences in any of the categories between the 2 groups. The 2-year survival rate of both groups was 100% without any locoregional recurrence. Although there was some skin toxicity, these instances were not severe and they cleared on their own within 6 weeks. The most common problems encountered by patients were breast fibrosis and altered pigmentation.

CONCLUSIONS: A shortened whole-breast hypofractionated irradiation schedule with a concomitant boost is as effective as standard radiation and may be a reasonable alternative following breast conservation surgery.

Keywords: Combined Modality Therapy, Breast Neoplasms - surgery, Dose Fractionation, Mastectomy, Segmental, Prospective Studies, Survival Rate

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750