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Global perspective on implementing ultra-hypofractionated radiation therapy in breast cancer: a survey-based analysis
Tinatin Alaverdashvili1, Angel Montero2, Philip Poortmans3,4
1Department of Radiation Oncology, Todua Clinic, 13 Tevdore Mgvdeli St., 0112, Tbilisi, Georgia. tinatinalaverdashvili@gmail.com.
Background:
This study aimed to investigate global practice patterns, barriers, and physician perspectives on implementing ultra-hypofractionated radiation therapy (UHF-RT) in breast cancer treatment.
Materials And Methods:
A 19-question online survey, distributed to radiation oncologists worldwide between February and August 2025, assessed UHF adoption, clinical use, barriers, training, and outlook. Chi-square tests compared adoption by institutional type, economic context, and physician experience (p < 0.05).
Results:
89 responses from 24 countries were analyzed. Moderate hypofractionation (MHF) predominated (70.8%), followed by UHF (20.2%). Overall, 80.9% had applied UHF, mainly for breast-only cases. Reported barriers included lack of clinical guidelines (49.2%), insufficient training (20.3%), equipment limitations (18.6%), and reimbursement issues (16.9%). No significant differences in adoption were found, though trends showed higher use in academic centers and high-income countries.
Conclusions:
UHF is increasingly adopted worldwide, yet MHF remains predominant. Standardizing education, infrastructure, and reimbursement policies could support wider global use.
