e20584 Background: Life expectancy increased in female population and we are facing higher incidence of breast cancer in patients over 80 years old. Considering age related comorbidities they are usually frail population which often can not receive chemotherapy or radical surgery. We evaluated once-a-week hypofractionated radiotherapy together with hormonal therapy for these patients in terms of local control, side effects and progression-free survival. Methods: Between January 2002 - December 2006 in the Oncological Institute of Bucharest Radiotherapy Department 59 patients with the age over 80 have been treated with once weekly hypofractionated radiotherapy associated with hormonal therapy. The clinical stage distribution was: stage I 9 patients, stage II 28 patients, stage III 22 patients. Radiation therapy was delivered once a week, dose=6.5 Gy, to a total dose of 32.5 Gy in 5 fractions for tumor site and lymph nodes. All patients received post irradiation hormonal therapy: Tamoxifen intended for 5 years. Results: 45 patients supporting the entire treatment (77%). 8 patients received less than 32.5 Gy (13%). 6 patients received less than 2 years hormonal therapy (10%). Radiotherapy led to: CR in 13 patients, PR in 31 patients, SD in 10 patients and PD in 5 patients. Toxicities after radiation therapy have been: grade 1–2 nausea in 6 patients, radiodermitis in 43 patients (grade 1–2 - 36 patients and grade 3–4 - 7 patients) and grade 1–2 leucopenia in 18 patients. Late toxicities of all grade occurred in 49.15% of patients: skin reaction - 19 patients, lung fibrosis - 8 patients (2 symptomatic and 6 asymptomatic) and cardiac failure - 2 patients. After one year 12 patients were free of disease and 38 patients were free of progression. 9 patients progressed; 4 of them died, 2 from their cancer. After two years 10 patients were free of disease and 35 free of progression. 14 patients dead and 4 death were cancer-related. Progression-free survival rate at 2 years was 76.27%. Conclusions: Definitive hypofractionated radiotherapy allows a good local control with acceptable toxicity and good progression free survival rate. This schedule associated with hormonal therapy is a good alternative to conventional multimodality treatment and to standard fractionation for patients over 80 years old. No significant financial relationships to disclose.
Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer
