Result and outcome of shorter fractionation schedule for post-operative cancer breast patients

Background: The purpose of this prospective study is to determine the effectiveness and cosmetic outcome of shorter fractionated radiotherapy in post-operative invasive breast cancer patients. Methods: Between July 2009 and June 2011, 216 post-operative cancer breast patients were treated with this regimen on cobalt60. The chest wall and supraclavicular area were treated using a tangential parallel pair, & direct supraclavicular portal with wedges as necessary, to a dose of 40 Gy / 15 fractions (study group) (133 cGy for tangential and 266 cGy for supraclavicular field each). (Control Group received 50 Gy / 25#) No additional boost was given. The median duration of follow-up surviving patients are 3 years. Results: From July 2009 to July 2011 (2 years), 216 histopathologically proven cases of Invasive ductal carcinoma of Breast were included in this study. All patients with early and locally advanced stage breast cancer were treated with hypofractionated and conventional schedule of radiotherapy. At baseline 80.19% in the study and 75.45% of patients in the control group were being rated as excellent or good. At 2 years, the percentages of patients with an excellent or good cosmetic outcome were 75.80% in the study and 73% in the control group. Grade II skin reactions were more in control (60%) as compared to study group (49%). A radiation schedule delivering 40 Gy / 15 # seems to offer control  rates of locoregional tumour relapse & late adverse effects at least as favourable as the standard schedule of 50 Gy / 25#. Conclusion: Shorter fractionation schedule is very much effective in preventing recurrent breast cancer and it provides a high level of patient satisfaction as well as reduce money and overall treatment time. Its shorter duration offers the added advantage of a more efficient use of resources and greater patient convenience.