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 ID: 1032197
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1. Hypofractionation in breast cancer Yadav BS, Sharma SCAssistant Professor, Dept. of Radiotherapy, PGIMER, Chandigarh
2. IntroductionBreast cancer is as sensitive to fraction size as the normal tissues of the breast and underlying rib cageHypofractionated radiotherapy is an established treatment in patients with breast cancer.
3. AimTo see impact of hypofractionated radiotherapy in breast cancer patients.Cosmetic outcomeLocoregional recurrenceDisease free survivalOverall survival
4. Materials and methodsDuration: Jan 1987 to Dec 2007Analysis: RetrospectivePatient No: 2756Mean age: 49 yearsVariables: Age, menopausal status, tumour stage, histology, grade, DRP, ECE, LVI, ER/PR & HER-2 statusTreatment: Radiotherapy, chemotherapy & hormonesMedian FU: 64 months
5. Age Menopausal status
6. SurgeryTM+AC: 2139(83.5)BCS: 420(16.5)Median No. of nodes: 10:11
7. Pathological Characteristics N(%)Tumor stage T1T2 T3T4 1361(53)1218(47)Histology IDC ILC Others 2328(90.5)90(3.5)151(6)Grade I&II III Unknown 2022(79)446(17)101(4)DRP Involved Free 291(11)2278(89)
8. Nodal status44%
9. Characteristics N(%)LVI Yes No 522(20)2247(80)ECE Present Absent 175(7)2394(93)ERPositiveNegativeUnknown 1220(47)414(16)935(37)PRPositiveNegativeUnknown 1044(40)870(33)955(27)HER-2PositiveNegativeUnknown 256(10)993(38)1330(52)
10. Radiotherapy PMRT CW 35Gy/15#/3wks SCF 40Gy/15#/3wksIntact Breast 40Gy/16#/3wksMachine: Cobalt/LinacFields: Tangential SCF
11. Systemic Treatment Chemotherapy N(%)Yes 1077(42) No 1492(58)Hormones Yes 1837(70) No 722(30)
12. Results
13. LRR
14. Distant metastases
15. Cosmesis
16. LRRFS93%70%RTNo RTp<0.001
17. Overall survival86%76%RTNo RTp<0.001
18. Dose & fractionationUKChd
19. 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.