13P - Hypofractionated radiotherapy in post operative breast cancer patients: 3-year clinical experience in a newly established cancer center

Background

Breast conserving surgery and post mastectomy breast irradiation has been established as a standard care for early breast cancer. RT dose of 45-50 Gy in 1.8-2 Gy per fraction & 42.5 Gy at 2.66 Gy per fraction. Tumor bed boost is recommended in patients at higher risk for local failure, age < 50 years, positive axillary nodes, LVSI, or close margins. Typical doses are 10-16 Gy at 2 Gy per fraction. All dose schedules are given 5 days per week. Post mastectomy regional radiotherapy (PMRT) is effective at preventing locoregional failure (LRF).

Methods

All patients were staged accordingly. Data collection would be in tabulated sheet. This retrospective chort study conducted in cancer center, CMH, Dhaka, Bangladesh, including patients with carcinoma of breast treated with hypofractionated radiotherapy during last 03 year. The patient treated with 3DCRT, IMRT by LINAC, 6 MV photon and appropriate electron energy.

Results

Out of 82 patients,12 had undergone BCS and 70 mastectomy. Mean age of population was 52 years. 80% were T1&T2 in BCS group whereas most patients in mastectomy group had T3&T4 (60%). 45% were node negative in BCS group. TNBC accounted for 13% and their mean age was 43 yrs. Acute skin toxicity at the end of treatment was Grade 1 in 94% of mastectomy group and 71% in BCS group. Grade 2 toxicity was 6% in mastectomy group and 23% in BCS group. Grade 3 was 6% in BCS group. No grade 3 toxicity in mastectomy patients and grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had Grade I skin reaction which was only 7% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. 3% of BCS and 8% of mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mastectomy had developed metastatic disease at the time of evaluation.

Conclusions

Hypofractionated RT is well tolerated with less acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centre to increase machine output time. The study is on-going to assess long term results.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.