Effectiveness and safety of hypofractionated radiation therapy in postmastectomy breast cancer

Abstract

Objectives Hypofractionated radiotherapy (HFRT) is an alternative treatment in postmastectomy breast cancer
women. This study was conducted to assess the effectiveness and safety of HFRT at the Chonburi Cancer Hospital by
evaluating the outcomes of treatment.

Methods Clinical and demographic characteristics of 486 breast cancer patients with mastectomy who had received
complete adjuvant radiotherapy treatment between January 2012 and December 2015 were retrospectively analyzed.
All patients had received HFRT 2.65-2.67 Gy daily for 15-18 fractions for a total dose of 39.75-47.86 Gy. The study
outcomes included 5-year local recurrence free survival (LRFS), disease free survival (DFS), and overall survival (OS)
including grade 2 or more acute and late toxicities in different age groups.

Results The median follow-up was 66.1 months (range 2.1-100.4 months). Five-year LRFS was 93.7%, five-year DFS
was 61.5% and 5-year OS was 66.4%. There was slightly higher grade 3 arm edema and cardiovascular toxicity in the
> 60 age group. There were no differences in the incidence rates of other toxicities including skin atrophy, subcutaneous
tissue fibrosis, brachial plexopathy and pulmonary fibrosis among the different age groups.

Conclusions The implementation of HFRT in postmastectomy breast cancer patients is both effective and safe. HFRT is
particularly beneficial during the COVID-19 pandemic as it consumes fewer hospital resources.