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Abstract
Aim. To evaluate the efficacy and safety of ultrahypofractionated postoperative irradiation of remaining breast tissue following breast-conserving surgery.
Materials and methods. A comparative analysis of moderate- and ultra-hypofractionated postoperative irradiationy for early-stage breast cancer was performed on 194 patients. For 90 women, the treatment consisted of five daily fractions of 5/2 Gy each, to a total dose of 26 Gy. In 104 women, postoperative irradiation consisted of 16 daily fractions of 2.66 Gy, to a total dose of 42.56 Gy, followed by additional irradiation of the tumor bed, with a total dose of 10–16 Gy. The frequency of local recurrences was calculated using the Kaplan–Meier method. Data from dynamic observation and the results of telephone surveys of the patients included in the study were analyzed to evaluate cosmetic outcomes using the Russian version of the BREAST-Q™ - Version 2.0 questionnaire.
Results. Local control was achieved for five years in 97.8% of patients after ultrahypofractionated radiotherapy and in 96.2% after moderate hypofractionation (p = 0.259). Analysis of cosmetic outcomes revealed a significant difference in the frequency of skin hyperpigmentation. It was observed in 30 patients (33.3%) in the extreme hypofractionation group, compared to 18 patients (17.3% of cases) who received moderately hypofractionated irradiation (p = 0.01). There was no significant difference in the frequency or severity of other 'cosmetic' indicators, such as telangiectasia severity, skin dryness and irritation, pain intensity and skin edema, between the two groups.
Conclusion. The comparative analysis indicates that moderate and extreme hypofractionation regimens are equally effective and safe for the postoperative irradiation of residual breast tissue, and they may be considered for inclusion in clinical guidelines.
References
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