Acute and late adverse effects of breast cancer radiation: Two hypo-fractionation protocols

Background: Hypofractionated radiotherapy delivered a lower total dose of radiation in larger dose per-fraction over 3 weeks.Many randomized trials supported the comparable efficacy and toxicities of conventional radiotherapy schedule to differenthypofractionated regimens. Patients and methods: One hundred female patients having breast cancer post-surgery randomized into two arms of acceleratedhypofractionation; 39 Gy/13 fractions (group A) and 42.4 Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: There was a significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy. Grade I and IIdermatitis reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneousfibrosis among patients with group A (28%) compared with (18%) to group B that was statistical significance. Breast conservativesurgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Thirty-nine Gy in 13 fractions has higher acute dermatitis and chronic subcutaneous fibrosis for patients underwentbreast conservative surgery. We need longer follow up to evaluate the efficacy of both regimens as regard of local control andsurvival.