Md Shadab Alam, Roshan Perween and Shahid Ali Siddiqui
Aim: Comparison of two different radiation fractionation schedules is done in post mastectomy breast cancer cases in relation to loco regional control, acute and late toxicities, survival and overall treatment time (O.T.T). The patient, tumor and treatment related parameters have also been studied.
Materials and Methods: Between December 2011 and December 2013, hundred patients of stage II to III carcinoma breast treated with surgery and chemotherapy received adjuvant radiation therapy with two different fractionation regimes:
(Regimen-1, 50 patients) - 42.5 Gray/16 fractions/3.1 weeks @ 2.6 Gray/ fraction (#)
(Regimen-2, 50 patients) - 50 Gray/25 fractions/5 weeks @ 2 Gray/fraction (#)
Assessment was done for loco regional and distant control rate, acute and late radiation toxicities, and quality of life related parameters.
Results: Maximum numbers of patients were of 40-50 year age, post-menopausal, with invasive ductal carcinoma of grade III and stage II or, III. Regimen 1 in comparison to Regimen 2 resulted in comparable loco regional and distant control rate. It also led to significantly less O.T.T. without any significant difference regarding acute and late radiation toxicities. It resulted in significant improvement in patient’s quality of life parameters related to O.T.T.
Conclusion: In breast cancer patients undergoing post mastectomy radiotherapy, accelerated hypofractionated radiation (42.5 Gy/16 #/3.1 weeks) in comparison to the conventional radiotherapy (50 Gy/25#/5 weeks) results in comparable loco regional and distant control rates without any significant difference regarding acute and late radiation toxicities. It also leads to significant reduction in overall treatment time with significant improvement in patient’s quality of life parameters related to O.T.T.