A Comparative Analysis of Hypofractionated and Conventional Radiotherapy for Breast Cancer Patients: A Retrospective Cohort Study
Main Article Content
Abstract
Breast cancer presents a substantial health challenge in Africa and marked by a continuous rise in its incidence and prevalence. The complexities of managing breast cancer on the continent are exacerbated by limited access to healthcare resources and high rates of late-stage disease at initial diagnosis. Recent studies comparing hypofractionated radiotherapy (HFRT), considered cost-effective and non-inferior to conventional fractionated radiotherapy (CFRT), have shown no significant differences in outcomes. This underscores the potential significance of HFRT in breast cancer treatment. Despite encouraging findings from researchers in developing countries, there is a noticeable lack of data on HFRT outcomes, particularly in Sub-Saharan Africa. This retrospective study analyzed individuals diagnosed with early, locally advanced or oligometastatic cancer, and who underwent treatment between January 2010 and December 2020 at Inkosi Albert Luthuli Central Hospital in the KwaZulu Natal Province of South Africa. Relevant clinical treatment details and follow-up information were retrieved from the patients' medical electronic records. This retrospective study included 645 breast cancer patients, categorized into early (37.7%), locally advanced (59.9%), and oligometastatic (2.4%) stages. Treatment modalities included surgery (100%), chemotherapy (77.8%), endocrine therapy (38.8%), and targeted therapy (4.8%). All patients received radiotherapy, with a predominant utilization of HFRT (83.7%) over CFRT (16.3%). Notably, there was no statistically significant difference (p=0.91) observed in survival probability between patients who received HFRT and CFRT. The findings of this study suggest that, in a low-income setting, HFRT does not exhibit a significant variance in survival outcomes compared to CFRT for breast cancer patients. However, to validate this conclusion, additional large-scale randomized clinical trials are imperative.
Keywords:
Breast cancer; conventional radiotherapy; hypofractionation; survival outcome, Sub-Saharan Africa
Article Details
How to Cite
MALLUM, Abba et al.
A Comparative Analysis of Hypofractionated and Conventional Radiotherapy for Breast Cancer Patients: A Retrospective Cohort Study.
Medical Research Archives, [S.l.], v. 12, n. 8, aug. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5585>. Date accessed: 06 sep. 2024.
doi: https://doi.org/10.18103/mra.v12i8.5585.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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6. Anderson KN, Schwab RB, Martinez ME. Reproductive risk factors and breast cancer subtypes: a review of the literature. Breast cancer research and treatment. 2014;144:1-10. DOI: 10.1007/s10549-014-2852-7.
7. Kanadys W, Barańska A, Malm M, Błaszczuk A, Polz-Dacewicz M, Janiszewska M, Jędrych M. Use of oral contraceptives as a potential risk factor for breast cancer: A systematic review and meta-analysis of case-control studies up to 2010. International journal of environmental research and public health. 2021;18(9):4638.
Doi: 10.3390/ijerph18094638.
8. Beltrán Ponce SE, Abunike SA, Bikomeye JC, et al. Access to radiation therapy and related clinical outcomes in patients with cervical and breast cancer across sub-saharan africa: A systematic review. JCO Global Oncology. 2023;9:e2200218. Doi: 10.1200/GO.22.00218.
9. Sanft T, Day A, Peterson L, et al. NCCN Guidelines® insights: survivorship, version 1.2022: featured updates to the NCCN guidelines. Journal of the National Comprehensive Cancer Network. 2022;20(10):1080-1090.
Doi: 10.6004/jnccn.2022.0052.
10. Gradishar WJ, Anderson BO, Abraham J, et al. Breast cancer, version 3.2020, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2020; 18(4):452-478. Doi: 10.6004/jnccn.2020.0016.
11. Bhuiyan M, Maele M, Mavhungu R, Ooko F. Breast cancer: Factors influencing late-stage presentation at the Mankweng Hospital breast cancer clinic, Polokwane, Limpopo Province, South Africa. South African Medical Journal. 2022;112 (11):906-910. Doi.org/10.7196/SAMJ.2022.v112i11b.16834.
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13. Agodirin O, Aremu I, Rahman G, Olatoke S, Olaogun J, Akande H, Romanoff A. Determinants of delayed presentation and advanced-stage diagnosis of breast cancer in Africa: a systematic review and meta-analysis. Asian Pacific journal of cancer prevention: APJCP. 2021;22(4):1007. Doi: 10.31557/APJCP.2021.22.4.1007.
14. Kraus RD, Weil CR, Abdel-Wahab M. Benefits of adopting hypofractionated radiotherapy as a standard of care in low-and middle-income countries. JCO global oncology. 2022;8. DOI: 10.1200/GO.22.00215.
15. Elmore SN, Polo A, Bourque J-M, et al. Radiotherapy resources in Africa: an International Atomic Energy Agency update and analysis of projected needs. The Lancet Oncology. 2021;22 (9):e391-e399.
Doi: 10.1016/S1470-2045(21)00351-X.
16. Ndlovu N. Radiotherapy treatment in cancer control and its important role in Africa. Ecancermedicalscience. 2019;13. Doi: 10.3332/ecancer.2019.942.
17. IAEA. Directory of radiotherapy centers. 2022. Https://dirac.iaea.org/Query/Countries.
18. Gradishar WJ, Moran MS, Abraham J, et al. Breast cancer, version 3.2022, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2022; 20(6):691-722. Doi: 10.6004/jnccn.2022.0030.
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