Phase II clinical trial of central hypofractionated three-dimensional radiotherapy for patients with early-stage breast cancer after breast-conserving surgery

Abstract

Objective To observe the therapeutic effects,cosmetic results,and toxicities of central hypofractionated three-dimensional radiotherapy for patients with early-stage breast cancer after breastconserving surgery.Methods From February 2009 to February 2010,45 patients with pTis-2N0-1 M0 breast cancer after breast-conserving surgery were enrolled in the trial.Three-dimensional conformal radiotherapy or simplified intensity-modulated radiotherapy was applied to each patient.The hypofractionated radiotherapy schedule was 43.5 Gy/15 fractions/3 weeks to the whole breast,with a boost of 8.7 Gy/3 fractions/3 days to the tumor bed.The dose was 2.9 Gy per fraction;the total course of treatment was 24 days.Thirty-three patients received chemotherapy,including neoadjuvant chemotherapy in 2 patients and postoperative adjuvant chemotherapy in 31 patients.Locoregional control and overall survival were calculated by Kaplan-Meier method.Results The follow-up rate was 100％.The 2-year locoregional control and overall survival were both 100％,and one patient had a single bone metastasis.Of the patients,1 developed grade 2 breast edema,6 developed grade 2 breast fibrosis,1 developed grade 2 upper extremity edema,4 developed grade 2 radiation dermatitis,5 developed grade 1 radiation pneumonitis,and 2 developed grade 2 radiation pneumonitis.Compared with the conventional fractionated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery,the hypofractionated three-dimensional radiotherapy had the number of fractions decreased from 30 to 18,course of treatment shortened from 40 days to 24 days,and the cost cut from ￥ 30450 to ￥ 19770.Conclusions The central hypofractionated three-dimensional radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery have good therapeutic effects and cosmetic results and acceptable toxicities,as well as significantly reduced time and cost of treatment. Key words: Breast neoplasms/surgery ; Surgery, breast-conserving surgery; Breast neoplasms/radiotherapy; Radiotherapy, hypofractionation; Treatment outcome