الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Adjuvant radiotherapy is an integral part of breast cancer treatment, and there was a great evolution of radiotherapy techniques over the past few years. Intensity-modulated radiation therapy (IMRT) was developed in the 1990s as a modern technique aiming to spare normal tissues from toxic effects of radiotherapy.
This part of the work aimed at comparing the IMRT technique to the 3D-coformal radiotherapy technique (3D-CRT) in early breast cancer patients regarding the occurrence of acute skin toxicities and treatment-related lymphopenia (TRL).
It is a prospective study conducted on 100 eligible patients who were divided equally between two groups; the first, are patients received adjuvant radiotherapy using IMRT technique and the second group were those who received 3D-CRT.
Results showed that sever acute skin toxicity or moist desquamation in IMRT group was 6 % versus 18 % in 3DCRT group (P < 0.05). And, the sever TRL with IMRT technique was 9% compared 21 % among those of the 3D-CRT group (P < 0.05). The IMRT technique resulted in statistically significant lower incidence of sever acute skin toxicities as well as less sever TRL when compared with 3D-CRT technique.
Part (II): The Retrospective Part:
The prognostic value of treatment-related lymphopenia has been studied in various solid malignancies such as high-grade glioma, pancreatic cancer and lung cancer. It is associated with inferior outcome in each of these cancers. However, additional studies are needed to determine its prognostic value in patients with breast cancer. If similar relationships between treatment-related lymphopenia and survival are found in breast cancer, research efforts will be redirected to novel approaches to spare lymphocytes from the toxic effects of radiotherapy and thereby hopefully improve overall disease outcome.
The work proposed in this part of the study is designed to study prognostic value of treatment-related lymphopenia in early-stage breast cancer patients who receive adjuvant radiotherapy. This was done through a retrospective study that collected the clinico-pathological and laboratory data from patients with early stage breast cancer who received adjuvant loco-regional radiotherapy from 1994 to 2004 at Medical Research Institute Hospital in Alexandria. Then, the well-known clinico-pathologic parameters associated with patient survival and disease relapse were statistically analyzed along with treatment-related lymphopenia using univariate and multivariate analysis.
There were 253 patients’ files with complete data after scanning of whole eligible patients’ files between the year 1994 to 2004 in the Medical Research Institute of Alexandria. The 5-years disease-free survival in patients who did not develop lymphopenia was 50.7% versus 40.6% in patients who was reported to develop lymphopenia with P value of 0.103. The 5-years overall survival in patients who did not develop lymphopenia was 80%, and in the lymphopenia group it was 73.4% (P = 0.157). It was concluded that the treatment-related lymphopenia did not negatively affect the patients’ survival.