DOI: 10.4103/mgmj.mgmj_15_26 ISSN: 2347-7946

A prospective comparative study between hypofractionated radiotherapy of 3 weeks versus 1 week in the treatment of breast carcinoma

Tanmoy Basak, Linkon Biswas, Sumitava De, Arpan Khatua

Abstract

Background:

Hypofractionated radiotherapy (40 Gy in 15 fractions over 3 weeks) is currently the standard protocol in managing breast cancer. Recently, ultra-hypofractionated radiotherapy (26 Gy in five fractions over 1 week) has been increasingly adopted. This study aimed to compare dosimetric parameters, acute toxicity, and patient compliance between hypofractionated radiotherapy schedules delivered over 3 weeks and 1 week.

Materials and Methods:

This was a prospective, two-arm study conducted at a single institution among patients with breast carcinoma attending the Department of Radiotherapy from November 2022 to June 2024. Patients were randomly assigned to two groups: the study group received 26 Gy in five fractions over 1 week, while the comparison group received 40 Gy in 15 fractions over 3 weeks. The study evaluated and compared acute toxicity profiles, patient compliance, and dose constraints between both groups.

Results:

The occurrence of both Grade 1 and Grade 2 acute skin toxicity was slightly lower in the 26 Gy schedule compared with the 40 Gy/15 fractions schedule (45.3% vs. 47.8% and 29.7% vs. 39.1%, respectively). The average lung V20 was significantly lower in the study group (9.94 ± 7.9 Gy vs. 28.41 ± 5.5 Gy, P < 0.001). For patients with right-sided breast cancer, the average heart dose was significantly lower in the study group than in the control group (4.09 ± 2.04 Gy vs. 13.94 ± 5.8 Gy, P < 0.001). Similarly, for left-sided breast cancers, the average heart dose was significantly lower in the study group (4.14 ± 1.4 Gy vs. 15.23 ± 4.1 Gy, P < 0.001).

Conclusion:

The 1-week ultra-hypofractionated radiotherapy schedule appears as effective as the 3-week hypofractionated regimen in achieving disease control, with a similar acute event profile.

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