Acute Skin and Pharynx Complications Following Adjuvant Hypofractionated Versus Conventional Radiotherapy in Patients with Breast Cancer

Background: Hypofractionated radiotherapy (HF) method was introduced to overcome the quickly growing tumor cells as well as shortening whole treatment course in solid tumors such as breast cancers. Here, we compared the incidence of dermatitis and pharyngitis among patients undergoing HF versus conventional fractionationated (CF) radiation therapy following surgery for breast cancer. Methods: During this prospective study, women who had undergone breast surgery since 2015-2017 were included in the initial sample population. 40 patients were included for analysis in each arm of CF and HF. Patients treated by CF received 50 Gy with 2.0 Gy per each fraction session and in group of HF; 42.4 Gy was delivered in 2.66 Gy per fraction sessions for 3 months. Severity of acute dermatitis and pharyngitis was recorded for all patients in both groups based on regular examinations during and after the radiation therapy. Results: 18 out of 40 patients in the conventional group experienced dermatitis of which 11 and 3 were grade 2 and 3, respectively. In the HF group, 8 experienced only grade 1 acute dermatitis. Thus, acute radiation-induced dermatitis occurred more frequently (P=0.017) and more severely (P=0.002) in the conventional group within 3 months of follow-up. There was no statistically significant difference in incidence of pharyngitis between the two groups. Conclusion: There was a statistically significant difference in occurrence of dermatitis between the two groups of conventional radiotherapy and those who received hypofractionated radiation. Incidence and severity of dermatitis was more common in those who received conventional radiotherapy in comparison to hypofractionated method.