Hypofractionation in post-mastectomy breast cancer patients: seven-year follow-up

To compare three fractionation schedules in post-mastectomy patients treated with radiotherapy as regard acute and early late effects as well as local recurrence rates. One hundred and seven breast cancer patients treated with modified radical mastectomy and adjuvant radiotherapy ± adjuvant systemic treatments between November 2001 and July 2004 were enrolled in this study. Patients were categorized into three groups. Group A (41 patients) received conventional fractionation 50 Gy over 25 fractions. Group B (36 patients) received other fractionation regimen 45 Gy over 17 fractions. Group C (30 patients) received 40 Gy over 15 fractions. The median follow-up period was 23 months. There has been no statistical significant difference in local control (P = 0.88), pain (P = 0.98), telangectasis (P = 0.23), fibrosis (P = 0.13), arm oedema (P = 0.96) or pigmentation (P = 0.80) between the three groups. GII-III Erythema was significantly higher in the two hypofractionation arms compared to the control arm (P = 0.001). Although acute skin reactions were higher in the hypofractionated arms, there was no significant difference in the local recurrence rates or late radiation effects. A national randomized multicentre study is recommended to explore this further.