Authors: Professor Dr Rowshan Ara Begum, Dr Sura Jukrup Momtahena, Dr Aditi Paul Chowdhury.
Institution: Ahsania Mission Cancer & General Hospital
Hypofractionated radiation therapy (HypoRT) is a treatment schedule that divides the total dose of radiation into large doses, with treatments given once a day or less often. HypoRT has been widely adopted worldwide because it reduces the length of treatment courses, which can improve healthcare resources and patient convenience. Adjuvant radiotherapy following neoadjuvant chemotherapy and surgery is now recognized as an effective treatment for locally advanced breast cancer (LABC), particularly in patients with positive lymph nodes who undergo mastectomy and axillary clearance. This approach has been shown to significantly reduce locoregional cancer recurrence and breast cancer mortality. Traditionally, the administration of adjuvant radiotherapy for these cases has involved a schedule of 25 fractions of 2 Gy delivered over a span of 5 weeks.
This quasi-experimental study conducted from January 2021 to January 2023 at the Ahsania Mission Cancer & General Hospital, investigated 15 different fraction regimens delivering a total dose of 40 Gy over a period of 3 weeks.
This study evaluates the safety of the international standard 15 fraction regimen of adjuvant radiotherapy along with the toxicity and rate of recurrence, conducted at a tertiary level hospital in Bangladesh, specifically focusing on locally advanced breast cancer (LABC). The study also indicates that 56% of the total patient had no local recurrence and the toxicity evaluation also showed no significant difference with the international guideline.
This study is conducted to ensure that the treatment regimen is not less effective than traditional methods for local cancer control of LABC survivors and is equally safe compared to the 25 fraction regimens for patients with locally advanced breast cancer (LABC) in Bangladesh.