Retrospective Study Evaluating Hypofractionated Radiotherapy Concomitantly with Weekly Boost for Early Breast Cancer Patients Treated with Conservative Breast Surgery

Background: Breast cancer is the most life- threatening cancer, as it remains 
leading cause of women death among less developed countries, however in 
developed countries. Based on radiobiological models, it was evident that 
hypofractionated radiation schedules used as adjuvant treatment for breast 
cancer offer equivalent local control to standard conventional radiation therapy 
by giving larger doses per fraction in shorter period of time. 
Patients & Methods: This retrospective study included 50 female patients with 
early stage (T1-2 N0-1 M0) breast cancer who underwent breast conservative 
surgery. All patients received adjuvant radiotherapy at the radiotherapy 
department of South Egypt Cancer Institute (SECI), Assiut University, Egypt, 
between 2013 and 2016. All patients received post-operative chemotherapy then 
adjuvant whole breast radiotherapy (42.5GY/16 fractions) with once weekly 
concomitant photon boost of 1 GY for 3 weeks (total boost dose 3GY) with 
whole radiotherapy schedule period of 16 days (3 weeks). The patients were 
followed up for 60 months. 
Results: The 5 years disease free survival was 94% and the local recurrence 
2%, distant metastasis 4%, and 5 years overall survival was 96%. Cosmetic 
outcome was Excellent or good in most of cases, with few poor and fair 
outcomes. 
Conclusion: hypofractionation with integrated boost as adjuvant treatment for 
breast cancer is an acceptable option that provides excellent local control and 
low toxicity. Hypofractionated whole breast irradiation with concomitant 
weekly boost appears feasible and safe.