Abstract
High-quality evidence supports that hypofractionated radiation treatment (HFRT) is as effective and safe in early breast cancer as conventionally fractionated radiation treatment. HFRT with fewer treatments has potential benefits for both patients and radiation departments. Despite this, concerns about local control and toxicity with HFRT persist, such that many eligible patients do not receive HFRT. The local recurrence rates and acute toxicity after HFRT was analyzed in our center in Christchurch, New Zealand.
An audit was undertaken of all early breast cancer (T1-2 and N0-1) patients treated with HFRT from Jan 21, 2004, to December 31, 2006, dating from the adoption of HFRT in our department. Sixty-eight percent of the patients during this time received HFRT (274/402). Acute toxicity was prospectively recorded and local, regional and distant recurrences were documented.
A total of 274 patients were analyzed with a median follow-up of 7 years (range 0.55-9.5 years). Eleven of 274 patients had local recurrence only. The local recurrence-free survival was 97.2% and 95.8% at 7 years. The skin, lethargy and breast pain acute toxicity was less than grade 3, except for one patient experiencing grade 3 breast pain.
Low local recurrence rates and acceptably low acute toxicity were achieved in a local setting with HFRT, comparable to results achieved in large randomized controlled trials. HFRT is a valid option for eligible patients and its use should be encouraged.