Evaluation of the Clinical Outcomes of Altered Fractionated Radiotherapy in Node Positive Breast Cancer (A Retrospective Study)

Background Hypofractionated radiotherapy schedules provide alternative shorter courses of radiotherapy of more than 2 Gy per fraction and lower total doses compared to the conventionally fractionated schedule of 1.8–2.0 Gy per fraction in 25 fractions. Hypofractionated radiotherapy offers the advantage of improving patients’ convenience and reducing cost and resource requirements. Aim To evaluate the efficacy and toxicity of hypofractionated radiotherapy compared to the conventional schedule. Methods In this retrospective study, the clinical data of 140 patients of node positive breast cancer patients were analyzed. Radiation toxicities and locoregional recurrence were compared between patients who received conventionally fractionated radiation schedule and those who received hypofractionated radiation schedules. Results After a median follow-up of 48 months, the incidence of loco-regional recurrence was comparable between the conventional and hypofractionated arms; 4% vs 3.1%, respectively (P-value = 0.769). Documented acute skin toxicity with ≥ grade 3 was found in 10.6% of the conventional group and in 5.6% of the hypofractionated group (p = 0.409). Grade 1 late lung toxicity was manifested in 6.1% of the conventional group and 7.5% of the hypofractionated group and G2 lung toxicity was found in one case only (1.9%) in the hypofractionated group (p = 0.596). Cardiac toxicity was documented in five cases; 9.4% and 5.1% in the conventional group and hypofractionated groups, respectively (pvalue=0.486). Conclusion Hypofractionated radiotherapy is comparable to conventional radiotherapy regarding locoregional tumor control and treatment toxicities.