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<p>The primary objective of our study was to estimate the difference in locoregional recurrence-free survival (LRFS) and investigate the influence of various clinical factors on the risk of locoregional recurrence (LRR) in post-mastectomy breast cancer patients treated with two different radiation fractionations. Data from 317 post-mastectomy patients were retrospectively analyzed. The conventional fractionation schedule was 50&#xa0;Gy in 25 fractions; the hypofractionated schedule was 42.6&#xa0;Gy in 16 fractions. LRFS between the two fractionations was estimated and compared. The median LRFS for hypofractionated radiation (<i>n</i> = 194) is 52.5&#xa0;months (95% <i>CI</i> 23.0–60.0); for conventional fractionated radiation (<i>n</i> = 123) is 60.0&#xa0;months (95% <i>CI</i> 35.5–60.0; <i>p</i> = 0.008), significant difference at first, but not after further analysis. With univariate cause-specific risk analysis, the hazard ratio (<i>HR</i>) for recurrence with hypofractionated radiation was 1.55 (95% <i>CI</i> 0.76–3.15; <i>p</i> = 0.2). The cause-specific HR for competing events with hypofractionated radiation was 1.04 (95% <i>CI</i> 0.67–1.60; <i>p</i> = 0.9). With multivariable cause-specific hazard analysis, <i>HR</i> for recurrence with hypofractionated radiation vs. conventional is 1.27 (95% <i>CI</i> 0.61–2.65; <i>p</i> = 0.5). Nodal stage is a significant predictor of LRR. Positive margins are associated with higher LRR risk (<i>HR</i> 2.02; <i>p</i> = 0.052). Age, tumor stage, chemotherapy, histology, tumor grade, and hormone receptor status did not significantly influence LRR risk. For post-mastectomy breast cancer patients, hypofractionated radiation treatment is not different from conventional fractionation in achieving locoregional control. Lymph node positivity is a crucial determinant of local recurrence.</p>

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Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy

  • 期刊论文

  • 发表日期：

    2025年2月3日

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  • Suma Susan Meloot,
  • Ciniraj Raveendran,
  • IP Yadev

摘要

The primary objective of our study was to estimate the difference in locoregional recurrence-free survival (LRFS) and investigate the influence of various clinical factors on the risk of locoregional recurrence (LRR) in post-mastectomy breast cancer patients treated with two different radiation fractionations. Data from 317 post-mastectomy patients were retrospectively analyzed. The conventional fractionation schedule was 50 Gy in 25 fractions; the hypofractionated schedule was 42.6 Gy in 16 fractions. LRFS between the two fractionations was estimated and compared. The median LRFS for hypofractionated radiation (n = 194) is 52.5 months (95% CI 23.0–60.0); for conventional fractionated radiation (n = 123) is 60.0 months (95% CI 35.5–60.0; p = 0.008), significant difference at first, but not after further analysis. With univariate cause-specific risk analysis, the hazard ratio (HR) for recurrence with hypofractionated radiation was 1.55 (95% CI 0.76–3.15; p = 0.2). The cause-specific HR for competing events with hypofractionated radiation was 1.04 (95% CI 0.67–1.60; p = 0.9). With multivariable cause-specific hazard analysis, HR for recurrence with hypofractionated radiation vs. conventional is 1.27 (95% CI 0.61–2.65; p = 0.5). Nodal stage is a significant predictor of LRR. Positive margins are associated with higher LRR risk (HR 2.02; p = 0.052). Age, tumor stage, chemotherapy, histology, tumor grade, and hormone receptor status did not significantly influence LRR risk. For post-mastectomy breast cancer patients, hypofractionated radiation treatment is not different from conventional fractionation in achieving locoregional control. Lymph node positivity is a crucial determinant of local recurrence.