Abstract:
Objective
To evaluate the efficacy and safety of hypofractionation radiotherapy in patients with early breast cancer after breast-conserving surgery.
Methods
A prospective study was conducted in 120 patients with early breast cancer after breast-conserving surgery in the Third People's Hospital of Hainan Province from February 2010 to January 2011. Based on their own wishes, the patients were divided into two groups: conventional dosage group (50.0 Gy, 25 times, n=60) and hypofractionation whole-breast radiotherapy group(41.6 Gy,16 times, n=60). The patients were followed up for 5 years. The 5-year local recurrence rate, 5-year regional recurrence rate, distant metastasis rate, non-breast cancer specific mortality,incidence of adverse events in radiotherapy, cosmetic outcome and quality of life were compared between two groups. The rates between two groups were compared using χ2 test or Fisher exact test, cosmetic outcome using Mann-Whitney U test,SF-36 scores on quality of life using t test.
Results
The 14.2% of patients were missed in follow-up (17/120). Totally 103 patients were enrolled in this study, including 50 patients in conventional dosage group and 53 patients in hypofractionation group. There was no significant difference in 5-year local recurrence rate,5-year regional recurrence rate, distant metastasis rate and non-breast cancer specific mortality between conventional dosage group and hypofractionation group [6.0% (3/50) vs 3.8% (2/53), P=0.676;0(0/50)vs 1.9%(1/53), P=1.000;2.0%(1/50)vs 3.8%(2/53),P=1.000;0(0/50)vs 1.9%(1/53),P=1.000]. There was no significant difference in cosmetic outcome (Z=-1.494,P=0.135) and each aspect of SF-36 scores on quality of life including physical health, social function, physical role, physical pain,psychological health, emotional role, energy and overall health(t=0.629, 1.748, 0.673, 0.894, 1.649,1.276,1.300,0.887; all P＞0.050). However, the incidence of adverse events in hypofractionation group was significantly lower than that in conventional dosage group [64.2% (34/53) vs 82.0% (41/50), χ2 =4.141, P= 0.042].
Conclusion
Compared with conventional dosage, hypofractionation radiotherapy has a lower incidence of adverse events and higher safety, without increasing the efficacy in early breast cancer after breast-conserving surgery.
Key words:
Breast neoplasms,
Radiotherapy,
Treatment outcome,
Evaluation studies
Wenjian Wang, Shiyun Qin, Lijun Chen. Efficacy and safety of hypofractionation radiotherapy in patients with early breast cancer after breast-conserving surgery[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(04): 213-217.