Comparative Early Toxicities of Hypofractionated Versus Conventional Adjuvant Radiotherapy in Patients with Early Breast Cancer After Mastectomy

Background: Hypofractionated radiotherapy reduces treatment duration compared with conventional radiotherapy. However, evaluating early treatment-related toxicity is essential, particularly in resource-constrained settings.

Objective: To compare early treatment-related toxicities between hypofractionated and conventional adjuvant radiotherapy in post-mastectomy patients with breast cancer.

Methods: This prospective quasi-experimental study was conducted at the National Institute of Cancer Research and Hospital, Dhaka, from June 2013 to May 2014. Sixty patients with stage IIB ductal carcinoma were enrolled. Thirty received hypofractionated radiotherapy (40 Gy in 15 fractions over 3 weeks), while 30 received conventional radiotherapy (50 Gy in 25 fractions). Hematological, skin, pulmonary, and cardiac toxicities were assessed weekly during treatment and monthly for three follow-up visits using established toxicity grading criteria.

Results: No statistically significant differences in hematological or skin toxicities were observed between groups during treatment (p > 0.05). Skin toxicities were predominantly grade 0 or 1. Pulmonary and cardiac toxicities remained grade 0 in all patients during the assessed early treatment periods. At the first follow-up, grade 0 hematological toxicity was observed in 28 patients receiving hypofractionated radiotherapy versus 24 receiving conventional radiotherapy. Follow-up toxicity differences were not statistically significant (p > 0.05).

Conclusion: Hypofractionated radiotherapy demonstrated a comparable early toxicity profile to conventional radiotherapy in post-mastectomy patients with stage IIB breast cancer. Its shorter treatment duration may reduce patient burden and optimize radiotherapy resource utilization in resource-constrained settings.