HYPOFRACTIONATEDRADIOTHERAPY OF BREAST CANCER IN ELDERLYWOMEN

Introduction:Breast cancer remains the first malignantpathology in women and itsdiagnosis in elderlywomenislate. The aim of ourworkis to evaluate the effectiveness of hypofractionatedradiotherapy in the treatment of breast cancer in elderlywomen. Material And Methods: This is a retrospectivestudy of 171 patients aged over 65 yearsfollowed for invasive breast cancer and whoreceived adjuvant hypofractionatedradiotherapy at the radiotherapydepartment of CHU Hassan II Fez fromJanuary 2012 to December 2016. Results: The frequency of breast cancer in womenaged over 65 yearswas 7.31%. The averageage of our patients was 70 years (65-88 years) of which 40% wereolderthan 70 years. 8.5% of patients had a familyhistory of breast cancer. The delay of consultation was 10 months. A breast nodule was the revealingsign in all patients withinflammatorysigns in 4.6%axillaryadenopathywasfound in 20% of patients. All cancers werehistologicallyproven. The cancer wasinfiltratingductal in 90% of cases. 27% of the tumorswereScarff-Bloom and Richardson grade I, 45% grade II, 30% grade III. Hormone receptorswereexpressed in 77% and HER positive in 10% of patients. 83% underwentmastectomywithlymphnode dissection followed by adjuvant radiotherapyaccording to the hypo-fractionatedprotocol: total dose of 42Gy on the wall, of which 32% of patients alsoreceivedlymphnode irradiation, fractionation 2.8Gy/Fr in 15 sessions, spread over 19 days 17% of the patients had conservative surgeryassociatedwith adjuvant externalradiotherapy on the breastaccording to the sameschemewith a boost of 11.8Gy on the tumorbed, spread over 25 days.After a medianfollow-up of 5 years, overallsurvivalwasestimated at 84.2%, locoregionalrecurrence-free survival at 84.7% and metastaticrecurrence-free survival at 83%. Acute toxicityconsisted of radiodermatitis in 81% of patients, and post-radiation fibrosis in 15%, and no long-termcardiac or pulmonarytoxicitywasobserved. Conclusion: For elderly patients, adjuvant hypofractionated irradiation seems to be a good alternative, with a good rate of local control, and withoutincreasedtoxicity.