An observational study comparing the dosimetry and clinical effects of conventional versus hypofractionated radiotherapy in elderly patients of early breast cancer
Year: 2025
Type: article
Abstract: INTRODUCTION: Hypofractionated radiation therapy after Breast Conserving Surgery in patients of early breast carcinoma results in equivalent clinical outcome but better cosmesis as compared to conventional therapy. In this study we have compared the dosimetry and clinical outcome between Hypofractionated and Conventional whole breast radiation followed by boost therapy after patients had undergone breast conserving surgery for early breast cancer. AIMS AND OBJECTIVES: 1. Dosimetric analysis and toxicity assessment between conventional and Hypofractionated radiation therapy.2. Comparative analysis of late toxicity between two groups. MATERIALS AND METHODS: In the department of Radiation Oncology in a Tertiary Care Hospital, 100 patients between the age group 65-75 years were selected as per inclusion criteria of the study and there were 60 patients in the conventional group and 40 in the hypofractionated group respectively. All the patients underwent treatment in Varian Truebeam Linear accelerator with appropriate radiation planning after undergoing Breast Conserving Surgery along with adjuvant chemotherapy when indicated.The conventional group received a dose of 50 Gy in 25# followed by boost of 10 Gy in 5 # and the hypofractionated arm received a dose of 42.5Gy in 16# followed by a boost of 12.5Gy in 5 # . The post-operative tumour cavity was irradiated along with axillary lymph nodes when indicated. All the patients in both arms were assessed for toxicity related to therapy and quality of life as per EORTC Q45 in 2 years following treatment completion. All statistical tests were done by SPSS version 23. Unpaired t-test was used for dosimetric comparison. Comparison of QOL and toxicity was done by Chi-square test respectively between two groups. A p-value of < 0.05 was taken to be significant. RESULTS: At the end of 2 years, 54 patients in conventional group and 38 patients in hypofractionated group could be assessed respectively and rest in both groups had lost to follow-up due to logistical reasons. There was no significant difference in dosimetry between the two groups as per unpaired t-test (P value >0.05). In terms of Quality of Life assessment in two years following the completion of therapy the conventional arm had more toxicity than hypofractionated arm as per Chi-square test (P value <0.05). Chi-square test revealed patients who had conventional therapy had worse cosmetic outcome and increased incidence of myelotoxicity than in those who received hypofractionated therapy, both statistically significant (P value < 0.05). There was no incidence of locoregional relapse in either groups. CONCLUSION: Hypofractionated whole breast Radiation therapy followed by boost therapy with can result in less toxicity and thus better cosmetic outcome and almost equal dosimetric results compared to Conventional Radiotherapy in patients after breast conserving surgery, thus comparatively increasing their quality of life.
Authors: Bappaditya Chhatui, Niladri Roy, Shinjini Chakrabarty, Alakananda Choudhury, Aishwarya Ravy, Justice Mazumder, Dharma Majhi
Institution: Medical College and Hospital, Kolkata
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4409123614