Atef, M., El Sheikh, E., Ellithy, M., Naguib, K., Tawfik, A. (2019). Randomized Prospective Study Comparing Conventional Versus Hypofractionated Adjuvant Radiotherapy in Node-Positive Breast Cancer. Research in Oncology, 15(2), 46-52. doi: 10.21608/resoncol.2019.12516.1078
Mai Atef; Eman El Sheikh; Mahmoud A. Ellithy; Khaled Naguib; Amr S. Tawfik. "Randomized Prospective Study Comparing Conventional Versus Hypofractionated Adjuvant Radiotherapy in Node-Positive Breast Cancer". Research in Oncology, 15, 2, 2019, 46-52. doi: 10.21608/resoncol.2019.12516.1078
Atef, M., El Sheikh, E., Ellithy, M., Naguib, K., Tawfik, A. (2019). 'Randomized Prospective Study Comparing Conventional Versus Hypofractionated Adjuvant Radiotherapy in Node-Positive Breast Cancer', Research in Oncology, 15(2), pp. 46-52. doi: 10.21608/resoncol.2019.12516.1078
Atef, M., El Sheikh, E., Ellithy, M., Naguib, K., Tawfik, A. Randomized Prospective Study Comparing Conventional Versus Hypofractionated Adjuvant Radiotherapy in Node-Positive Breast Cancer. Research in Oncology, 2019; 15(2): 46-52. doi: 10.21608/resoncol.2019.12516.1078
Randomized Prospective Study Comparing Conventional Versus Hypofractionated Adjuvant Radiotherapy in Node-Positive Breast Cancer
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Hypofractionated radiotherapy in early breast cancer yields equivalent or better outcome in terms of efficacy, toxicity, cosmesis and cost-effectiveness. However, its role in node-positive breast cancer is less clear. Aim: To compare between adjuvant conventional and hypofractionated radiotherapy in node-positive breast cancer. Methods: Prospective pilot study of 66 node-positive breast cancer patients recruited over 1 year in a single institution. Patients were randomized to receive adjuvant conventional radiotherapy 200 cGy x 25 fractions with 200 cGy x 5 fractions boost to the tumor bed in case of breast conservation (control arm) or hypofractionated radiotherapy 266 cGy x 16 fractions with 266 cGy x 4 fractions boost to the tumor bed in case of breast conservation (intervention arm). The end points were disease-free survival, cosmetic outcome, ipsilateral arm lymphedema and acute skin reactions. Results: Disease-free survival did not differ significantly between the two treatment arms (p = 0.6) and the 2-year disease-free survival rate was 87% and 89% in the hypofractionated and conventional arms. The rate of excellent/good cosmetic score was higher in the hypofractionated arm than the conventional as rated by patients (71% vs. 46%, p = 0.182) and physicians (29% vs. 8%, p = 0.32). Hypofractionation, when compared to conventional fractionation, was associated with less arm lymphedema (22% vs. 40%, p = 0.149), dry desquamation (28% vs. 53%, p = 0.04), skin darkness (0% vs. 15%, p = 0.054) and wet desquamation (16% vs. 21%, p = 0.601). Conclusion: Hypofractionated adjuvant radiotherapy in node-positive breast cancer patients is equivalent to conventional fractionation as regards disease-free survival, cosmetic outcome and arm lymphedema with less early skin reactions.
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