Comparison of clinical efficacy of hypofractionated radiotherapy and conventional radiotherapy for early patients after breast conserving surgery

CAO Qian; WANG Yihai; HAN Youxi; AI Xiuqing; MAIMAITINIYAZI Simayili; MUSHAJIANG Munire

doi:10.3969/j.issn.1009-0460.2018.02.011

Abstract：Objective To compare the adverse reactions, cosmetic effects and clinical efficacy of hypofractionated radiotherapy and conventional radiotherapy after breast conserving surgery for early breast cancer. Methods One hundred and seventy-six early breast cancer patients (T0-2N0-1M0) were enrolled in our hospital from January 2014 to December 2016 and were assigned into hypofractionated group (n= 106) and conventional group (n = 70). In hypofractionated group, 106 patients received 16 fractions of 2.66 Gy for the total breast following 5 fractions of 2 Gy for local tumor bed. In conventional group,70 patients received 25 fractions of 2 Gy for the total breast following 5 fractions of 2 Gy for local tumor bed. We investigated the toxicity effects (acute and late skin reaction,bone marrow suppression, pharyngeal and digestive tract reaction) and cosmetic effects. The local control rate was evaluated after 3-year follow-up. Results There was no difference of acute radiation-induced skin reactions between both groups (P> 0.05). No significant differences were observed in terms of bone marrow suppression reaction, late skin reactions and radiation pneumonitis after radiotherapy between both groups (P>0.05). In hypofractionated group, cosmetic effect was excellent in 96 cases and good in 10 cases without poor beauty, and in conventional group, cosmetic effect was excellent in 66 cases and good in 4 cases without poor beauty. There were similar cosmetic effect between both groups (P>0.05). The length of hospital stay and cost in hypofractionated group were less than those of conventional group(P<0.05). The follow-up rate was 100％. The 3-year local control rates were 97. 1％c in hypofractionated group and 94.3％ in conventional group (P>0.05). As for hypofractionated group, 1 patient exhibited solitary bone metastasis in 6 months and 1 patient exhibited ipsi-lateral supraclavicular lymph node recurrence one year later. As for conventional radiotherapy, 2 patients suffered from recurrent lateral clavicle area at 12 and 18 months after radiotherapy. Conclusion After breast conserving surgery, the adverse reaction of whole breast hypofractionated radiotherapy is acceptable with better cosmetic effect, and the treatment time and cost can be significantly reduced. The curative effect is similar from that of conventional radiotherapy. It can be applied in clinical practice.