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Published on: February 6, 2019
[Hypofractionated whole breast irradiation: Pro and cons]
1Institut du cancer Courlancy, 38, rue de Courlancy, 51100 Reims, France. bcutuli@iccreims.fr
Summary
Shortened radiation therapy for breast cancer shows comparable local control and toxicity to standard regimens. Hypofractionated whole breast radiation is suitable for select patients without nodal involvement or chemotherapy candidacy.
Area of Science:
- Oncology
- Radiation Oncology
- Clinical Trials
Background:
- Rising breast cancer incidence necessitates efficient treatment options.
- Standard 5-week radiation therapy poses logistical challenges.
- Hypofractionated regimens offer a shorter alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of hypofractionated whole breast radiation therapy.
- To compare short-course radiation schemes with standard fractionation.
- To identify patient subgroups suitable for hypofractionated treatment.
Main Methods:
- Analysis of three prospective randomized trials and one pilot trial.
- Inclusion of a large patient cohort with 5-12 years of follow-up.
- Assessment of local control and toxicity outcomes.
Main Results:
- Hypofractionated schemes demonstrated equivalent local control to standard therapy.
- Toxicity profiles were similar between hypofractionated and standard regimens.
- Recommended hypofractionated schemes include 42.5 Gy/16 fractions/3 weeks, 40 Gy/15 fractions/3 weeks, or 41.6 Gy/13 fractions/5 weeks.
Conclusions:
- Hypofractionated whole breast radiation is a viable option for select breast cancer patients.
- Treatment is recommended for patients with favorable prognostic factors, no nodal involvement, grade<3 tumors, and not candidates for chemotherapy.
- Standard fractionation should be used for boost doses, and careful attention to dose heterogeneity for organs at risk is crucial.
