One-week adjuvant breast radiotherapy: Retrospective outcomes from a Johannesburg oncology unit

Background: A 1-week, ultra-hypofractionated adjuvant radiation regimen has been found to be non-inferior to the standard 3-week regimen in women with early breast cancer.Aim: The study aimed to compare the patient and treatment characteristics of women receiving a 1-week (26 Gy in 5 fractions) and standard 3-week (40 Gy in 15 fractions) adjuvant radiotherapy schedule.Setting: A radiation oncology unit in a quaternary state hospital, Charlotte Maxeke Johannesburg Academic Hospital, in South Africa.Methods: A retrospective review of medical records of women who received adjuvant breast radiotherapy between June 2020 and February 2022. Patient characteristics, treatment characteristics and acute toxicities were compared between those treated with the 1-week (26 Gy in 5 fractions) and the standard 3-week (40 Gy in 15 fractions) regimens.Results: Of 123 patients included, the median age was 51 years (range 29–75); 53.6% had stage III disease. Thirteen per cent received the 1-week regimen, and 87% received the 3-week protocol. Rates of acute dermatitis (p = 0.37), pneumonitis (p = 1.00), and fatigue (p = 1.00) were similar between groups. Waiting time to treatment was not significantly different (p = 0.67).Conclusion: Early toxicity profiles of the 1-week regimen are comparable to the standard 3-week protocol, supporting its feasibility in a public sector, low and middle-income country (LMIC) setting.Contribution: This study contributes to the growing body of research on breast cancer treatment and outcomes in LMICs.