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

TL;DR

This study compares the acute side effects of two breast cancer radiotherapy regimens in Sub-Saharan Africa, finding that hypofractionated treatment causes less overall toxicity.

Contribution

The study provides region-specific evidence on acute toxicity differences between conventional and hypofractionated breast cancer radiotherapy in Sub-Saharan Africa.

Findings

Dermatitis was the most common acute toxicity in both treatment groups.

Hypofractionated radiotherapy had a significantly lower overall acute toxicity score compared to conventional treatment.

No significant differences were found in individual toxicity types like pharyngitis or fatigue between the two groups.

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.

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