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Hypofractionation in breast cancer . Yadav BS , Sharma SC Assistant Professor, Dept. of Radiotherapy, PGIMER, Chandigarh. Introduction. Breast cancer is as sensitive to fraction size as the normal tissues of the breast and underlying rib cage
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Hypofractionation in breast cancer Yadav BS, Sharma SC Assistant Professor, Dept. of Radiotherapy, PGIMER, Chandigarh
Introduction • Breast cancer is as sensitive to fraction size as the normal tissues of the breast and underlying rib cage • Hypofractionatedradiotherapy is an established treatment in patients with breast cancer.
Aim To see impact of hypofractionated radiotherapy in breast cancer patients. Cosmetic outcome Locoregional recurrence Disease free survival Overall survival
Materials and methods Duration: Jan 1987 to Dec 2007 Analysis: Retrospective Patient No: 2756 Mean age: 49 years Variables: Age, menopausal status, tumour stage, histology, grade, DRP, ECE, LVI, ER/PR & HER-2 status Treatment:Radiotherapy, chemotherapy & hormones Median FU: 64 months
Surgery • TM+AC: 2139(83.5) • BCS: 420(16.5) • Median No. of nodes: 10:11
Nodal status 44%
Radiotherapy PMRT CW 35Gy/15#/3wks SCF 40Gy/15#/3wks Intact Breast 40Gy/16#/3wks Machine: Cobalt/Linac Fields: Tangential SCF
LRRFS 93% RT p<0.001 70% No RT
Overall survival 86% RT 76% No RT p<0.001
Dose & fractionation UK Chd
Conclusion • Hypofractionation reduces treatment time to half while maintaining cosmesis and control rates equal to conventional fractionation. • It will help the radiation centers worldwide to meet the growing need for radiation in breast cancer, particularly in developing countries where resources are limited.