Comparative Evaluation of two Different Fractionation Radiotherapy Schedules in Post Mastectomy Cases of Carcinoma Breast

Abstract

Background: Breast cancer is the most common malignant neoplasm and a leading cause of death in women worldwide. Radiation therapy for breast cancer is usually performed after surgery and is an integral component of breast-conserving therapy as well as after post mastectomy. The dose of radiation must be strong enough to ensure the eradication of cancer cells. Objectives: To compare two different dose fractionation radiotherapy schedules in terms of: a) Loco regional control & distant metastasis b) Acute and late radiation induced toxicities. Methodology: Study was prospective and patients were divided into two groups-Group A and Group B. Group A-These patients were given Accelerated Hypofractionated Schedule (Study group) -40 Gy/17 fractions/3.2 weeks @ 2.35 Gy/fraction. Group B-These patients were given Conventional Fractionation Schedule (Control group) -50 Gy/25 fractions/5 weeks @ 2 Gy/fraction. Results: The median age of patients in both groups was 47 years, and patients were followed up till 18 months. Treatment time in group A and group B were 3.2 weeks and 5 weeks respectively. Patients of both the groups tolerated radiation well with locoregional control, distant metastasis and acute and late radiation reactions comparable in both the groups and there was no difference statistically (p>0.05) . Grade 1 acute radiation dermatitis was the most common reaction. Acute radiation dermatitis in group A and group B was 87% and 85%, late reaction lymphedema was 17% and 15%, locoregional failure was 12% and 15%, distant metastasis was 7.5% and 5% respectively. Conclusion:From the present study we concluded that patients in both the regimen groups tolerated the treatment well with non significant difference (p value>0.05) in radiation toxicities. The overall treatment time (O.T.T.) in group A was significantly less in comparison to group B(p value<0.05).