الفهرس 
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Abstract
This study included 48 female patients with early stage breast cancer who underwent breast conservative surgery. Those patients attended to the Oncology Department in Sohage University Hospital, Egypt, between March, 2014 and July, 2018. Written consent was taken -#102;-#114;-#111;-#109; each patient then randomization was donning using sequential allocation so that patients were numbered according to their attendance -#102;-#114;-#111;-#109; 1 to 48 those numbered 1, 3, 5 (odd numbered) were treated according -#103;-#114;-#111;-#117;-#112; A protocol and those numbered 2, 4, 6 (even numbered) were treated according -#103;-#114;-#111;-#117;-#112; B protocol. br br A- Patients in -#103;-#114;-#111;-#117;-#112; A received 42.7 Gy in 16 fractions. The fractions were given as 5 days/week to whole breast plus once weekly concomitant boost dose of 1Gy to lumpectomy area immediately after whole breast irradiation. br br B- Patients in -#103;-#114;-#111;-#117;-#112; B received hypo fractionated radiotherapy 42.7 Gy in 16 fractions over 3 weeks to whole breast followed by sequential boost to tumor bed 10-16 Gy. br Four year over all survival rate for -#103;-#114;-#111;-#117;-#112; A was (91.67%) and -#103;-#114;-#111;-#117;-#112; B (87.50%) with no statistically significant difference P value=1.00, Four year disease free survival rate for -#103;-#114;-#111;-#117;-#112; A was (87.5%) and -#103;-#114;-#111;-#117;-#112; B (79.17 %) with no statistically significant difference P value=0.44. br Disease relapse occurred only in 8 patients (33.34%), distant recurrence for -#103;-#114;-#111;-#117;-#112; A was 3 (12.50%) and -#103;-#114;-#111;-#117;-#112; B was 4(16.67%), one patient in -#103;-#114;-#111;-#117;-#112; B (4.17%) developed nodal recurrence, -#119;-#104;-#101;-#114;-#101; no patient developed local recurrence with no statistically significant difference P value=0,44. br Studying many prognostic factors that may affect the local and distant relapse, there was no statistically significant difference as regard impact of age, family history, tumor size, tumor site, Tumor grade, HER2, type of radiotherapy on disease free survival. But there was statistically significant difference as regard relation of ER-PR to disease free survival p=0.01, 0.04 irrespectively. br Radiation toxicities (acute and late skin, lung, heart toxicities and arm lymphedema) evaluated according to the Radiation Therapy oncology Group. br Acute skin toxicities in our study were assessed during the treatment and up to 3 months after treatment end, the incidence of grade 1 (dry desquamation) was (41.67%) in -#103;-#114;-#111;-#117;-#112; A and (25.00%) in -#103;-#114;-#111;-#117;-#112; B and grad 2 was (8.33%) in -#103;-#114;-#111;-#117;-#112; A and (16.67%) in -#103;-#114;-#111;-#117;-#112; B. br Conclusion br The results of our study suggest that this radiation schedule (hypo fractionated WBI with weekly concomitant boost) may provide an alternative option to hypo fractionated WBI with sequential boost with acceptable acute and late toxicities, good compliance and excellent cosmesis. Large randomized trials and long term follow up are needed to confirm these favorable results.