Open AccessLong Term Arm and Shoulder Toxicities in Breast Cancer Patients Receiving Hypofractionated Radiation Therapy
Author(s) -
Prateek Daga,
Harish Kumar,
Neeti Sharma,
Shankar Lal Jakhar,
Kamlesh Kumar Harsh
Publication year - 2021
Publication title -
asian pacific journal of cancer care
Language(s) - English
Resource type - Journals
ISSN - 2588-3682
DOI - 10.31557/apjcc.2021.6.3.311-315
Subject(s) - medicine , lymphedema , breast cancer , radiation therapy , axilla , brachial plexus , mastectomy , supraclavicular fossa , asymptomatic , surgery , cancer , radiology
Aim: The purpose of this study is to evaluate the late toxicities in hypo fractionated radiation schedule in breast cancer patients with regional nodal irradiation (RNI), limited to axilla and supraclavicular regions. Late effects on arm and shoulder were noted as follows: skin edema (lymphedema), restricted shoulder movements (brachial plexus injury) and localised pain.Material and Methods: In this study we randomly enrolled 100 breast cancer post mastectomy cases in the year 2018. All cases were previously asymptomatic after surgery. They were prospectively treated with hypo fractionated local and regional nodal irradiation by 2.67 gray / fraction dose, total 15 fractions (total dose-40 gray). Evaluation was done at 12 months after completion of radiation therapy. Assessment was done by RTOG, LENT- SOMA scales. Results: Significant lymphedema was observed in 17 (17%) cases. Restricted arm mobility was seen in 14 (14%) of patients. Pain (moderate/severe) in arm and shoulder was most commonly seen, in 25 (25%) cases. Conclusions: As hypo fractionated regimes in breast cancer treatment have become new standard; its late term effects are significant and comparable to other conventional radiation therapy regimes. These studies need further and longer duration of evaluation.