THE ANALYSIS OF THE EARLY AND LONG-TERM RESULTS OF THE HYPOFRACTIONED RADIATION THERAPY AND IMPLEMENTATION OF THIS METHOD IN THE COMPLEX TREATMENT PROGRAM OF BREAST CANCER

Background: The Breast Cancer takes first place in structure of oncological incidence and mortality around the world. Diagnostics of the breast cancer at early stages has allowed changing approach to treatment of patients - replacement of carrying out radical mastectomies with organ-preserving operations with the subsequent radiation therapy. The problem of new techniques of postoperative radiation therapy with the hypofractionated radiation doses which at impact equivalent to a standard course on a tumor have smaller risks and terms of treatment is relevant. Simultaneous development of new technologies of radiation therapy promotes increase in frequency of application of the hypofractionated modes.

The goal is improvement of treatment results of the breast cancer patients due to development of the accelerated hypofractionated radiation therapy regimes and implementation of this method in a complex  treatment therapy of breast cancer.

Methods: Design of a research: controlled clinical trial.

160 patients, with executed radical mastectomies and organ-preserving operations, with histologically confirmed diagnosis "Breast cancer", are divided equally into two groups: main (hypofractionated radiation therapy) and control (traditional course of radiation therapy). Treatment was carried out according to clinical protocols.

Both groups are comparable on age, molecular and histologic types of tumors, staging.

When questioning and mathematical processing of results the EORTC QLQ-C30 Scoring Manual programs for EORTC QLQ-C30/BR23 were used. The reliability of distinctions was estimated by the Wilcoxon-Mann-Whitney method. The whole analysis was performed with SPSS ver.20 software.

Results: Having considered differences in groups with traditional and hypofractionated radiation therapy at the breast cancer patients is established statistically significant difference in favor of the last. Frequency of radiation damages at hypofractionated radiation therapy is lower than at traditional at the expense of smaller fractional doses of radiation on integuments.

At a meeting of Association of Oncologists of RK is offered entering of changes into the clinical protocol of diagnostics and treatment of the breast cancer No. 17 for November 27 of the 2017th year about hypofractionated radiation therapy in treatment of the breast cancer.

Conclusions: Increase in number of the patients revealed at early stages will allow carrying out organ-conserving operations reducing quantity of the approximate and remote postoperative complications. Widespread introduction of organ-preserving operations will demand the choice of the radiation therapy mode with increase the single focal dose, which influenced on decrease in a recurrence, at the same time providing the best cosmetic results and will reduce treatment terms.

The introduced technique of hypofractionated radiation therapy will allow making clinically safe and economically effective alternative of traditional radiation therapy.

Key words: radiation therapy, breast cancer, hypofractionation, early and long-term results.

Tasbolat A. Adylkhanov, http://orcid.org/0000-0002-9092-5060

Ainur S. Baissalbayeva, http://orcid.org/0000-0002-7092-7448

Yеvgeniya O. Kossymbayeva, http://orcid.org/0000-0003-2893-0384

Almagul S. Zhabagina, http://orcid.org/0000-0001-8956-6286

Alfiya R. Nazarova, http://orcid.org/0000-0002-5609-8655

 

Oncology and radiology department

Semey State Medical University,

Semey, Kazakhstan;

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Adylkhanov T.A., Baissalbayeva A.S., Kossymbayeva Yе.O., Zhabagina A.S., Nazarova A.R. The analysis of the early and long-term results of the hypofractioned radiation therapy and implementation of this method in the complex treatment program of breast cancer. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 6, pp. 53-66.