Efficacy of Hypofractionated Radiotherapy for Controlling Bleeding and Pain in Locally Advanced Breast Cancer

Abstract

Background: Locally advanced breast cancer (LABC) often presents with distressing symptoms such as bleeding and pain, significantly impairing patients’ quality of life and complicating the initiation of systemic therapies. Traditional radiotherapy regimens may be unsuitable for patients with limited life expectancy, and there is limited evidence on the role of hypofractionated radiotherapy in palliating these symptoms in resource-limited settings. Objective: To evaluate the efficacy of hypofractionated radiotherapy in controlling bleeding and pain among patients with locally advanced breast cancer, and to assess symptom resolution across different age groups. Methods: This prospective interventional study was conducted at the Department of Radiation Oncology, CMH Rawalpindi, enrolling 50 female patients with cT4 LABC, aged 20–70 years. Patients received hypofractionated radiotherapy (3–5 Gy per session, total 30–40 Gy across 6–12 sessions). Symptom status before and after treatment was recorded using a structured questionnaire. Ethical approval was obtained, and all participants gave informed consent in compliance with the Declaration of Helsinki. Data were analyzed using SPSS v25, applying descriptive statistics and chi-square tests for stratified analysis. Results: The mean age of participants was 41.06 ± 9.14 years. Post-treatment, bleeding was resolved in 82% and pain in 76% of patients. Stratification by age showed no statistically significant differences in bleeding (p = 0.719) or pain (p = 0.620) resolution, indicating consistent efficacy across age groups. Conclusion: Hypofractionated radiotherapy is a clinically effective and well-tolerated palliative option for managing bleeding and pain in LABC, improving patient comfort and supporting its integration into real-world palliative care pathways.