Retrospective Study of Cardiac Toxicity of Hypofractionated Radiotherapy in Left Sided Breast Cancer | ||
| SECI Oncology Journal | ||
| Volume 12, Issue 4, October 2024, Pages 395-403 | ||
| Abstract | ||
| Background and aim: Postoperative adjuvant breast radiotherapy is considered one of the main steps in management of breast cancer. Fortunately, there has been a marked revolution in breast radiation therapy techniques and nowadays efficiently sparing the heart without affecting either local control or overall survival is possible .But still at the present time some controversies as regards most effective fractionation schedule with least side effects and comparable to conventional fractionation .The purpose of this study is to assess the impact of high dose per fraction used in hypofractionation schedules (40Gy/15, 39Gy/13 or 42.5Gy/16) on the heart in left sided breast cancer patients and its relationship with the clinical outcome. Patients and methods: A retrospective study, enrolled a total of 175 women with non-metastatic left sided breast cancer in South Egypt Cancer Institute (SECI) from 2015-2020.All patients full filling eligibility criteria including patients with age 18-75 years old with left sided pathologically confirmed breast cancer and received 3D hypo fractionation radiotherapy after surgery, their medical reports were evaluated and their medical data were debriefed. They were followed to assess frequency of cardiac affection by echocardiography focusing on left ventricular ejection fraction at starting planned treatment protocol and re-evaluated 3 years after radiotherapy course. Results: 175 patients were accrued in this study, mean age was 53.30±9.46 years, and ninety-two (52.6%) women were pre/perimenopausal. Patients with T2 disease were the most common, also positive node were noticed in one hundred forty nine patients (84.9%). Ninety eight (56%) patients had stage-III disease, One hundred forty three (81.7%) of patients underwent modified radical mastectomy (MRM). Estimated patients received hypo fractionated 3D radiotherapy dose schedules (3900/13, 4005/15 and 4240/16) were (4%), (34.9%) and (61.1%), respectively. Overall survival in studied patients based on development of LV dysfunction was 5.2 years and DFS was 3.4years with no significant difference between both groups as regard survival who are affected with cardiac toxicity of any grade and those without cardiac toxicity. Conclusion: Cardiac toxicities is uncommon in women who received adjuvant breast irradiation with hypo-fractionated radiotherapy. Patients with advanced tumor stage, neoadjuvant chemotherapy and/or received trastuzumab are more vulnerable to develop LV dysfunction. | ||
| Keywords | ||
| Breast cancer; hypo-fractionated radiotherapy; cardiac toxicity | ||
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