Ultrahypofractionation in Larger Breast size, a single institute feasibility study

Mona Salem; Ahmad S. Ali; Hanaa Attia; Shaimaa Lasheen

doi:10.53730/ijhs.v6nS4.6439

Authors

Mona Salem
mona.m.salem@kasralainy.edu.eg
Assistant Lecturer, MSC, Clinical oncology department, Kasr Alainy School of Medicine, Cairo University, Egypt
Ahmad S. Ali Lecturer, MD, Clinical oncology department, Kasr Alainy School of Medicine, Cairo University, Egypt
Hanaa Attia Professor, MD, Clinical oncology department, Kasr Alainy School of Medicine, Cairo University, Egypt
Shaimaa Lasheen Associate Professor, MD, Clinical oncology department, Kasr Alainy School of Medicine, Cairo University, Egypt

Keywords:

Breast cancer, Radiotherapy, Hypofractionation, Once-weekly, large breast

Abstract

Background: After the standardization of adjuvant moderately hypofractionated whole reast radiotherapy (HF-WBRT) over 15-16 fractions, with the favorable long-term results of the K-FAST trial and with the uncertainty about the safety in large breast sizes. We tested the easibility of using once-weekly HF-WBRT over 5-weeks in patients with larger breast sizes. Patients and Methods: In this prospective phase-II study, patients with early breast cancer with breast size>500cc, after breast conservative surgery (BCS), received radiotherapy at a dose of 28.5Gy in 5 once-weekly fractions. Patients were categorized according to the breast size to medium and large. The primary endpoints were assessment of acute skin-toxicity and patients` quality of life (QoL); secondary endpoints were late skin and subcutaneous-tissue toxicity and cosmetic score. Results: Twenty-nine patients were recruited. The median duration of follow-up was 24-months. The mean tumor size was 2.1cm and 96.5% were node negative. Following radiotherapy, 96.5% had G0-2 acute skin-toxicity, all patients had G0-1 late skin-toxicity. Regarding cosmesis 91.7% of patients had Excellent-Good cosmetic score. No significant correlation was found between the breast size and the acute and late toxicities. The QoL was maintained during follow-up. Conclusion: The protocol showed acceptable toxicity profile regardless of the breast size.

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