Toxicity of Hypofractionated Radiotherapy Following Breast Conservative Surgery in Breast Cancer

Abstract

Background : Adjuvant radiotherapy has increased disease - free and overall survival rates in breast cancer. Conventional ly fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods : Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study , radiotherapy induced toxicity was evaluated. Results : In this study , the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity ( telangectasia , hyperpigmentation , and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion : The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.