Locally advanced breast cancers lead to debilitating local symptoms. Treatment of these women encountered commonly in less resourced countries, is not backed by strong evidence. We formulated the XXX and XXX B phase I/II studies to evaluate the safety and efficacy of hypofractionated palliative breast radiotherapy.

Two studies (35Gy/ 10 fractions -XXX) and (26Gy to breast/ 32Gy tumour boost in 5 fractions -XXX B) were designed with increasing hypofractionation to save overall treatment time from 10 to 5 days. We report the acute toxicity, symptomatic, metabolic response and quality of life (QOL) changes following radiotherapy.

Fifty eight patients, majority pretreated with systemic therapy, completed the treatment. No grade 3 toxicity was reported. Response assessment at 3 months showed improvement in ulceration (58% versus 22%, p=0.013), bleeding (22% versus 0%, p=0.074) within the XXX study. Similarly, in XXX B study, ulceration (64% and 39%, p=0.2), fungating (26% and 0%, p=0.041), bleeding (26% and 4.3%, p=0.074), discharge (57% and 8.7%, p=0.003) was reduced . Metabolic response was noted in 90% and 83% patients respectively in the two studies. Improvement in the QOL scores were evident in both studies. Only 10% patients' relapsed locally within one year.

Palliative ultra hypofractionated radiotherapy to the breast is well tolerated, effective and results in a durable response with improved QOL. This could be considered as a standard for locoregional symptom control.