Abstract
BACKGROUND Adjuvant radiotherapy is given following surgery in breast
cancer patients. Hypofractonated radiotherapy can significantly reduce the
waiting time for radiotherapy, working load on machines, patient visits to radiotherapy
departments and medical costs. Material and Methods 244 patients
with high-risk breast cancer (stage IIB, stage III and stage IA with any
of the following criteria: lymphovascular invasion, hormonal receptor negative,
young age) who underwent Breast conservative surgery (BCS) or Modified
radical mastectomy (MRM) were enrolled in this study. All patients received
adjuvant radiotherapy with different hypofractionation schedules either
3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions
using linear accelerator with 6 MV photon beam. Lateral/Medial tangential
and Ipsilateral supraclavicular fields were employed and the ipsilateral
axilla was also irradiated if required to the same dose with posteroanterior
field. Patients were followed every 3 mons for the first 2 years and every 6
mons thereafter. Outcomes were analyzed in terms of tumor control and survival.
Results 244 patients with high-risk breast cancer requiring postoperative
radiotherapy to the intact breast or chest wall were treated. The mean age
was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all
patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients
at site of operated scar & 8 patients at the regional lymph nodes. The median
follow up period was 75 months ranged from 49 to 102 months. Distant metastasis
free survival was 92.2%, the distant metastasis reported in 19 patients
which represent (7.8%) of all patients, median survival is 75 months ranged
from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded
that hypofractionated radiotherapy is a simple and effective protocol
in patients with high-risk breast cancer regarding tumor control and survival.