Treatment completion rates and toxicity of 5 fractions of adjuvant radiotherapy over one week in elderly breast cancer patients treated with lumpectomy

Álvaro Flores Sánchez, Jorge Contreras Martínez, Remedios Priego Ortiz

Abstract

Background: Elderly patients are usually frail and cannot attend a prolonged radiotherapy course. Many of them undergo mastectomy to avoid adjuvant radiotherapy thinking that they are not going to complete at least 15 fractions. Many studies have suggested hypofractionated radiotherapy in 5 days. We would like to describe the treatment completion rates and toxicity of 5 fractions of 520 cGy delivered within one week in patients over 70 years old treated with tumorectomy.
Methods: Between June 2016 and May 2019 we have analyzed retrospectively 23 patients treated with lumpectomy plus 5 fractions adjuvant radiotherapy. All patients had negative SLNB and aged between 70 and 93 years old. After finishing the RT treatment, follow up was made at 1 month, 3 months, 6 months and a year. This follow up was based on an interview and physical examination.
Results: Independently of their age, the treatment completion rate was 100%. Every patient finished the whole treatment with no interruptions. Regarding cosmetic or toxicity outcomes within one year, there was only one patient with grade I radiation induced dermatitis and 2 patients with pruritus.
Conclusions: Five fractions schedule within one week is well tolerated with no important severe side effects after one year. Elderly patients appreciate to make as short as possible the number of fractions, decreasing the number of days days they have to come to clinic, improving patient satisfaction and treatment completion rates.