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Comparison of two hypofractionated radiotherapy schedules in locally advanced postmastectomy breast cancer patients


1 Department of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2 Department of Radiation Oncology, Apex Cancer Institute, Apex Hospital, Varanasi, Uttar Pradesh, India
3 Department of Radiotherapy, SGPGIMS, Lucknow, Uttar Pradesh, India
4 Department of Radiotherapy and Oncology, Victoria Hospital, Port Louis, Mauritius
5 Department of Radiotherapy, National Cancer Institute, Jajjhar, Haryana, India
6 Department of Radiotherapy, AIIMS, Bhubaneshwar, Odisha, India
7 Department of Radiotherapy, AIIMS, New Delhi, India

Correspondence Address:
Neha Gupta,
Apex Cancer Institute, Apex Hospital, Varanasi - 2211 005, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_722_19

Introduction: The role of hypofractionated radiotherapy (HFRT) in postmastectomy breast cancer patients is not well established. This study was done to establish the role of two different HFRT schedules in the treatment of chest wall and regional lymph nodes after mastectomy. Materials and Methods: Between 2012 and 2016, consecutively registered patients of locally advanced breast cancer patients having undergone mastectomy and adjuvant radiotherapy (RT) at a tertiary cancer center were analyzed. Locoregional recurrence (LRR) was the primary endpoint, whereas overall survival (OS), disease-free survival (DFS), and both acute and late adverse events were secondary endpoints. Results: A total of 34 patients who were treated with 39 Gy in 13 fractions over 2½ weeks and 35 patients who were treated with 40 Gy in 15 fractions over 3 weeks were identified. The median follow-up period was 47 months and 63.5 months in the 39 Gy and 40 Gy arms, respectively. LRR was seen in 11.8% and 8.6% of patients in the 39 Gy and 40 Gy arms, respectively. OS at 4 years was 66% and 71.5% in the 39 Gy and 40 Gy arms, respectively. The mean DFS for 39 Gy and 40 Gy arms was 43.6 months and 66.4 months, respectively (P = 0.822). Acute skin toxicity was similar in the two groups. Arm edema was significantly more in the 40 Gy arm. Conclusion: The two HFRT schedules are equivalent to each other in terms of survival outcomes. Arm edema is higher with 40 Gy arm as compared to 39 Gy arm.


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    -  Choudhary S
    -  Gupta N
    -  Misra S
    -  Munnee NN
    -  Kumar A
    -  Ranjan R
    -  Dhar SS
    -  Kumar D
    -  Mourya A
    -  Aggarwal LM
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