Title: Comparative Evaluation of Hypofractionated and Conventional Fractionated Radiotherapy in Post Mastectomy Carcinoma Breast Patients
Authors: Dr Roshani Vyas, Dr Ashok Chauhan, Dr Paramjeet Kaur, Dr Joydeep Singh Vasant, Dr Jyoti Pannu, Dr Shashank Joshi, Dr Anil Khurana
Purpose: To compare the radiation induced toxicity and loco regional recurrence rates along with tolerability of hypofractionated radiation therapy with conventional fractionation radiation therapy in post modified radical mastectomy carcinoma breast patients.
Material and Methods: Sixty post modified radical mastectomised, histopathologically proven patients of breast carcinoma from October 2016 to October 2017.Group I patients received 42.7Gy/16Fr/3.1 weeks and Group II patients received 50Gy/25Fr/5weeks. Radiation induced toxicities were assessed using RTOG and WHO criteria each week during treatment & fortnightly for 1st month after treatment & also up to 6 months after treatment.
Results: A total of 60 (30 in each group) patients completed treatment and 6 months follow-up. At the end of treatment grade I skin reactions were seen in 15(50%) patients of group I and 9 (30%) patients of Group II, Grade II in 10(33.3%) patients of Group I and 9(30%) patients in group II, Grade III in 1(3.3%) patients of group I and 0 patients of group II, no Grade IV reactions in any patients. Grade I esophageal reaction was seen in 10(33.3%) patients in both the groups, Grade II in 3(10%) patients of Group I and 0 patients of Group II, no patient in Group II. Nausea and vomiting (WHO TOXICITY CRITERIA) Grade I was seen in 16(53.3%) patients of Group I and 13(43.3%) patients of Group II, Grade II in 3(10%) patients of Group I and 1(3.3%) of Group II. Local recurrence along with distant metastasis was noted in 5 patients of Group I and distant metastasis only in 5 patients of Group II at median follow up of 14 months.
Conclusion: Radiation induced acute toxicity was more in group I (hypofractionation group) as compared to group II (Conventional fractionation group) while late toxicity was similar in both groups, thus making it equally tolerable schedule. Whereas compliance was better in group I due to shorter duration of treatment. Local recurrence was noted in hypofractionation group (I) patients and not in conventional group (II). Distant metastasis occurrence was equal in both the groups at median follow up of 14 months after treatment.