Effect of public holidays causing interruptions and prolongation of radiotherapy in breast cancer patients


Year:

Session type:

Babita Jyoti1, Helen Wong1, Nicky Thorp1
1Clatterbridge Cancer Centre, Wirral, UK

Background

Uncompensted interruptions of treatment in patients receiving primary radical radiotherapy for squamous cell cancers is known to effect outcome. There is little evidence for this in adjuvant breast radiotherapy. It is advised that post operative irradiation in breast cancer patients should not be prolonged by more than 2 days (1).

Method

Data was collected retrospectively from case notes of patients receiving adjuvant radiotherapy in breast cancer over the Christmas period in 2006 and compared to the patients who completed treatment before the holiday period. A gap in treatment was defined as any interruption longer than 2 days.

Results

Of 114 cases, 63 had gaps and 52 patients had no interruption. Treatment areas included breast only (71/114), chest wall only (9/114), breast and LN site (11/114) and chest wall and LN site (23/114). Standard dose fractionation schedules were used. Fifty two patients had adjuvant chemotherapy and 84 received endocrine therapy. Number of gaps ranged from 1 - 4, majority (41/114) having 2 gaps and 1 patient had 4 gaps. The duration of each gap ranged from 3 - 7 days. Total duration of gaps ranged from 3-14 days with a median duration of 7 days (<5 days in 46.5% and> 5 days in 12.3%). Systemic relapses were as follows: 4 with gaps of <5 days, 2 with gaps of>5 days and 5 with no gaps. There were 4 local recurrences, 2 with no gaps, 2 with a 3 day gap and all 4 also relapsed systemically. Mean progression free survival was 61 months in the group with no interruptions and 66 months in the group with interruptions. This was not statistically significant (0.966).

Conclusion

Interruptions in radiotherapy did not significantly effect either local control or 5 year survival. Further studies are required to establish a safe minimum duration of interruption.