Hypofractionation in Locally Advanced Breast Cancer: “Flash” Scheme

Authors

  • Marisa Padilha Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.
  • Sara Gonçalves Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.
  • Carlos Fardilha Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.
  • Gilberto Melo Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.
  • Cristina Miranda Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.
  • Paula Alves Serviço de Radioterapia. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.4096

Abstract

Introduction: Breast cancer is a major cause of death in our country. The Department of Radiation Oncology of Portuguese Institute of Oncology in Coimbra are using a scheme of hypofraccionation called “Flash” as a treatment option for elderly patients or low performance status, with locally advanced breast cancer, or with stage IIb or IV, as a neoadjuvante or palliative aim. Objectives: Evaluation of the therapeutic response, for the group of patients selected, who did the hypofractionated schemed, in a retrospective study. Methods: Between January 2006 and December 2008, a total of 83 patients diagnosed with locally advanced breast cancer or with stage IIb or IV, were subjected to breast “Flash”. The radiation dose prescribed was 13Gy in 2 fractions in 3 days (in 23 patients – 27.7%) and 26 Gy in 4 fractions in 5 weeks (60 patients – 72.3%), with 4MV photons, in the sick breast. Global survival was evaluated using the Kaplan-Meier method. Statistical analysis was performed by applying the version 17.0 of SPSS and statistical tests were evaluated at a significance level of 5%. Results: 80 patients (96.4%) who have made breast “Flash” were female, aged between 59 and 93 years and performance status (Karnosfky scale) between 90 and 50%. In 72 patients (86.7%) the histology was invasive ductal carcinoma. Surgery was held in 53% of patients (44) after breast “Flash”, the radical modified mastectomy was the most common surgical technique. The diagnosis of bone metastasis was made in 10 patients (12%), while the global survival rate was 68.7% (57 patients). 10 patients (12%) died because disease progression or persistence. In 50.6% (42 patients) there was no evidence of disease progression and 3.6% (3 patients) showed clinical improvement. Conclusions: The “Breast Flash” is a safe treatment modality, in terms of secondary effects, and a valid therapeutic option for elderly patients or low performance status, with the diagnosis of locally advanced cancer or stage IIb or IV, as neoadjuvante, adjuvant or palliative aim. There is a little risk of relapse or progression in patients with good conditions, so the global survival rate is greater in these cases. There is a little iatrogenesis associated with this type of treatment; just one patient had grade III radiodermatitis.

Downloads

Download data is not yet available.

How to Cite

1.
Padilha M, Gonçalves S, Fardilha C, Melo G, Miranda C, Alves P. Hypofractionation in Locally Advanced Breast Cancer: “Flash” Scheme. Acta Med Port [Internet]. 2013 May 31 [cited 2024 Nov. 6];26(2):98-101. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/4096