Breast cancer radiotherapy in Sub-Saharan Africa: a comparative study of acute toxicity between conventional and hypofractionated treatment regimens.

Abstract

Hypofractionated radiotherapy for breast cancer has been increasingly adopted globally due to its comparable efficacy and reduced treatment burden. The study compared the incidence and severity of four main acute radiation-induced toxicities between breast cancer patients treated with conventional versus hypofractionated radiotherapy. Stratified purposive sampling was used to recruit participants into two groups: group #1 received conventional radiotherapy (50 Gy in 25 fractions over 5 weeks), whereas group #2 received hypofractionated radiotherapy (40.05 Gy in 15 fractions over 3 weeks). A closed-ended questionnaire administered by the researcher was used for quantitative data collection. The Common Terminology Criteria for Adverse Events tool (version 5) was used for grading acute toxicities. Data were analyzed using the Statistical Package for Social Sciences (version 23). The study involved 53 patients with a mean age of 47.9 years (± 12.4) ranging from 26 to 75 years. The patients had breast cancer ranging from stage IIA (13.2%) to IIIC (9.4%). A considerable majority (62.3%) were treated with conventional fractionation whereas 37.7% were treated with a hypofractionated regimen. Dermatitis was the most prevalent side effect among patients in both groups #1 (67%) and #2 (70%). There were no statistically significant differences in the incidence of dermatitis, pharyngitis, chest wall/ breast pain and fatigue between the two groups. However, the mean incidence of overall acute toxicity was significantly lower in group #2 (2.15 ± 1.14) compared with group #1 (2.42 ± 1.48), with a p-value of 0.001. Comparatively, the conventional 50 Gy dose regimen was associated with more acute radiation-induced toxicity.