Hypofractionated adjuvant whole breast radiotherapy: progress and prospects
Hypofractionated adjuvant whole breast radiotherapy: progress and prospects
Published results of randomised trials involving >7000 women confirm the safety and efficacy of hypofractionated schedules of adjuvant radiotherapy for women with early breast cancer using fraction sizes between 2 and 3 Gy assuming appropriate downward adjustments to total dose. Unnecessary concerns relating to heart tolerance, suboptimal dose distribution and duration of follow up need not discourage the routine adoption of 15- or 16-fraction schedules in women treated by breast conservation surgery for early breast cancer. Regardless of fractionation regimen, dose escalation to the index quadrant in high risk subgroups will result in a greater relative increase in late adverse effects than tumour control, a therapeutic disadvantage that can only be overcome by exploiting a marked dose-volume effect. A 15-fraction schedule of whole breast radiotherapy is unlikely to represent the lower limits of hypofractionation, and the preliminary results of a 5-fraction regimen are encouraging.
radiotherapy, hypofractionation, breast cancer, local tumour control, normal tissues, clinical trials
1288-1292
Yarnold, J.
0003b4fd-a371-4258-890f-ffd3d0b5c3a9
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
November 2010
Yarnold, J.
0003b4fd-a371-4258-890f-ffd3d0b5c3a9
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Abstract
Published results of randomised trials involving >7000 women confirm the safety and efficacy of hypofractionated schedules of adjuvant radiotherapy for women with early breast cancer using fraction sizes between 2 and 3 Gy assuming appropriate downward adjustments to total dose. Unnecessary concerns relating to heart tolerance, suboptimal dose distribution and duration of follow up need not discourage the routine adoption of 15- or 16-fraction schedules in women treated by breast conservation surgery for early breast cancer. Regardless of fractionation regimen, dose escalation to the index quadrant in high risk subgroups will result in a greater relative increase in late adverse effects than tumour control, a therapeutic disadvantage that can only be overcome by exploiting a marked dose-volume effect. A 15-fraction schedule of whole breast radiotherapy is unlikely to represent the lower limits of hypofractionation, and the preliminary results of a 5-fraction regimen are encouraging.
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Published date: November 2010
Keywords:
radiotherapy, hypofractionation, breast cancer, local tumour control, normal tissues, clinical trials
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 365594
URI: http://eprints.soton.ac.uk/id/eprint/365594
ISSN: 0284-186X
PURE UUID: f2332c0b-7a34-4876-a6fd-b11a5e68af8f
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Date deposited: 12 Jun 2014 10:41
Last modified: 14 Mar 2024 16:58
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Author:
J. Yarnold
Author:
J.S. Haviland
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