Evaluation of Three Weeks Hypofractionated Whole Breast Irradiation with a Sequential Boost in Breast Cancer Patients

Document Type : Original Article


Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt


Background:Breast cancer is a prevalent and dangerous disease. Breast-conserving surgery and radiation are typical treatments for early breast cancer.Hypofractionation can improve the treatment's cost-benefit ratio and shorten the waiting list while maintaining equivalent results.The purpose of the study was to assess the effectiveness of hypofractionated whole breast irradiation with sequential boost, and 15 treatment days in early breast cancer.

Patient and Methods:Patients were allocated into 2 Arms, Arm A (standard hypofractionation arm, whole breast irradiation HF-WBI 40Gy/15fractions followed by boost 10Gy/5 fractions) and Arm B (short hypofractionated arm, HF-WBI 36.63Gy/11followed by boost of 13.32Gy/ 4 fractions), with an equivalentdose to the regional nodes if indicated in both arms. Patients were followed at 3, 6, 9 and 12 months after treatment and acute and chronic toxicity were recorded.

Results:One hundred and twentyfemale patients were included in the study.There was no statistical significant difference between both groups regarding acute toxicity (skin was the most frequently affected in both groups). Patients with grade 2 toxicity showed improvement over 3 months’ period (from 23.33% to 10% in arm A and from 26.67% to 16.67% in arm B). Arm A had significantly lower skin toxicity than arm B over 12 months’ follow up. No patients had any chronic laryngeal, cardiac or lung toxicity symptoms at 6, 9 and 12 months of follow-up.

Conclusion:A shortened 3-week HF-WBI schedule has cost and time benefit and itis safe and effective with low toxicity as standard 4-weeks HF-WBIand may be a reasonable alternative following breast conservation surgery.


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