A Retrospective Study Comparing Hypofractionated Radiotherapy and Conventional Radiotherapy in Postmastectomy Breast Cancer
Attapol Pinitpatcharalert MD*, Imjai Chitapanarux MD**, Juntima Euathrongchit MD**, Ekkasit Tharavichitkul MD**, Vimol Sukthomya MD**, Vicharn Lorvidhaya MD**
Affiliation : * Division of Therapeutic Radiology and Oncology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand ** Department of Radiology, Faculty of Medicine, Chiang Mai Universiy, Chiang Mai, Thailand
Background : The conventional radiotherapy (CRT) in postmastectomy breast cancer is 1.8-2.0 Gy daily for 25 fractions,
while hypofractionated radiotherapy (HFRT) delivered dose in fewer fractions with larger radiation intensity. The present
study compares the efficacy of HFRT and CRT.
Material and Method: From 2004 to 2006, 215 patients were retrospectively reviewed. Sixty seven patients received CRT
and 148 patients received HFRT (2.65 Gy in 16-18 fractions). Five-year locoregional control (LRC), disease free survival
(DFS), overall survival (OS) and toxicities were analyzed.
Results : Median follow-up was 39 months. Five-year LRC was 86.6% in CRT and 85.8% in HFRT (p = 0.852). Five-year
DFS was 62.7% and 69.6% (p = 0.136) in CRT and HFRT, respectively. Patients who received HFRT had significant increase
in 5-year OS (62.7% and 73.0% (p = 0.048). No difference of toxicities including changes in chest wall appearance, skin
fibrosis, brachial plexopathy, arm edema, pulmonary fibrosis, rib fractures and cardiovascular events was found between
two groups.
Conclusion : HFRT is as effective as CRT in postmastectomy breast cancer.
Keywords : Breast cancer, Hypofractionation, Radiotherapy, Postmastectomy
