Comparison of hypofractionated and conventional radiotherapy protocols in breast cancer patients: A retrospective study

Abstract

Objectives: Conventional fractionated irradiation (CF) has major implications on both patient quality of life and radiotherapy (RT) departments. Hypofractionated (HF RT) schedule would be more convenient for patients and for health care providers. We retrospectively evaluated OAS, DFS, locoregional control, and treatment related toxicities, in patients treated with CF and HF schedules. Methods: This retrospective study analyzed the medical records of female breast cancer patients with infiltrating duct carcinoma, and underwent surgery and received adjuvant systemic and radiation therapies.The schedule of adjuvant radiotherapy was divided into two groups; CF (n = 162), and HF (n = 181).The log-rank test examined differences in OAS and DFS rates. Data of radiation toxicities, and disease relapse in both CF and HF groups were compared using Chi-square test. Results: The median follow up was 42 months (range: 6 - 127 months. Four-year OAS & DFS rates for the whole group were 86.5% & 83.8% respectively. There were no significant differences in 4-year OAS regarding age at diagnosis (p = 0.18), HR 0.66, 95% CI: 0.36 - 1.22, disease stage (p = 0.06, HR status (p = 0.1), HR 0.52, 95% CI: 0.241 - 1.135, type of surgery (p = 0.28), HR 1.44, 95% CI: 0.74 -2.79, and fractionation schedule (p = 0.12), HR 0.63, 95% CI: 0.35 - 1.34. Disease stage (p = 0.032), in favour of early stages and fractionation schedule (p = 0.039), HR 0.553, 95% CI: 0.315 - 0.970 in favour of HF were associated with significant differences in 4-year DFS rates. Conclusion: Hypofractionated radiation therapy was safe and resulted in comparable OAS and disease relapse rates, to that in CF. © 2012 El-Sayed MI, et al.