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SECI Oncology Journal /
 SECI Oncology Journal /
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[9002235.] رقم البحث : 9002235 -
Evaluation of cosmesis after hypo fractionated, norm fractionated and intraoperative breast radiotherapy: A photographic evaluation study of patients from prospective trials; KOSIMA, TARGIT-A and TARGITE /
تخصص البحث : General
  SECI Oncology Journal / / vol.6 - 2018
  ساره محمد عباس عبد الحفيظ
  طارق ابو بكر محمد - مؤلف رئيسي
  hypo fractionated,breast radiotherapy,cosmesis
  Abstract
Purpose: Photographic documentation of breast changes after breast radiotherapy (RT) is a helpful tool to both subjectively and
objectively evaluate cosmesis. This study aimed to evaluate cosmesis in breast cancer patients after receiving hypo fractionated whole
breast RT (HF-WBRT), norm fractionated (NF-WBRT), intraoperative RT (IORT) or combined WBRT/IORT within prospective
studies.
Methods: After excluding files with missing or inadequate photos from three prospective clinical trials (KOSIMA, TARGIT-A &
TARGIT-E) 205 patients were included in subjective analysis while 185 patients were included in the objective analysis 2 years after
RT respectively. Subjective evaluation was done using the Harvard scale. Objective evaluation was done by assessing percentage
breast retraction. Based on the treatment received, patients were divided into 5 groups: 1.HF-WBRT 40.05Gy/2.67Gy±Boost, 2.NFWBRT 50Gy/2Gy±Boost, 3.NF-WBRT 56Gy/2Gy, 4.IORT 20Gy, 5.IORT 20Gy +WBRT 46Gy/2Gy.
Results: Subjectively, the rate of acceptable cosmesis was 84% while objectively it was around 56%. At 2 years, there was neither a
subjective (p=0.55) nor objective (p=0.88) significant difference in cosmesis between the 5 treatment groups. Regarding possible
factors affecting cosmesis at 2 years, there were no differences concerning age, smoking, body mass index, chemotherapy, hormone
therapy or type of axillary surgery. Significantly better cosmesis was observed in patients with tumor location in the upper outer
quadrant (p<0.001) and with percentage of excised to total breast volume <10% (p<0.0294).
Conclusions: After two years of follow-up, adjuvant radiotherapy caused only minor cosmetic deterioration based on subjective
assessment of photographic documentation. The influence of the treatment method was minimal. Hypo fractionated WBRT and IORT
as a single treatment or as a boost were cosmetically similar to norm fractionated WBRT. Tumor location and excised breast volume
were the only factors significantly affecting cosmetic outcome.
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