Accelerated hypofractionated or conventional RT post BCS reoprted similar recurrence rates and cosmetic outcomes. Conventional RT delivers radiation dose of 50 Gy in 25 fractions in 5 weeks. Radiobiologic models suggests higher radiation doses over shorter period of time may produce similar outcomes. An accelerated, hypofractionated treatment also might be more convenient for patients and conserve resources, in developing countries where patient load is too much and the resources are limited.
100 patients were randomized to receive hypofractionated radiation with 40 Gy/15#/3 weeks and the control group receiving 50 Gy/25 #/5 weeks. Post radiation therapy all the patients were followed up regularly on monthly interval. Follow up assessment for quality of life made by EORTC questionnaire. All the patients in both study and control groups were assessed regularly and records maintained at weekly intervals with special attention to toxicity, physical examination, QOL scores and subjective evaluation were documented.
The patients in the study group as well as the control group were well matched in terms of age distribution (p value - 0.235).The difference in between both the arms regarding severity and incidence of dermatological toxicities was statistically insignificant (p value - 0.260) at the end of treatment. Radiation induced esophagitis was the main GI toxicity which increased towards the end of the treatment but statistically it was not significant in both the groups (p value - 0.356). Equal number of patients from study and control group showed grade I pulmonary toxicity after the follow up period of 6 months. The difference in both the group was statistically insignificant (p value -1.0).
The hypofractionated radiotherapy in post operative breast cancer patients is more relevant in the present context in our country where the case load is more and availability of the equipment is a major issue. So treating patients with hypofractionated RT will reduce the burden on the machine and will also reduce the number of the visits of the patient to the hospital. This short course RT has improved the compliance very much.
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