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Extreme hypofractionation in radiation therapy for patients with early breast cancer: what is the optimal technique?

Extreme hypofractionation in radiation therapy for patients with early breast cancer: what is the... Adjuvant external beam radiation therapy following breast‐conserving surgery is an integral component of treatment for patients diagnosed with early breast cancer. For many years, the established international standard has been the delivery of 25 daily fractions of 2 Gy encompassing the entire breast over 5 weeks. However, there is now established mature evidence in the form of 5 randomised clinical trials and a meta‐analysis1–6 for moderately hypofractionated radiation therapy of 15 to 16 fractions of 2.6 Gy. These have all demonstrated non‐inferior outcomes comparing the 3‐week regimen to the traditional 5–6‐week regimen in terms of safety and efficacy.Further to this, there is now emerging evidence supporting the use of an even more hypofractionated schedule of 5 fractions delivered over 1 week as shown by the FAST‐Forward trial.7 This three‐arm trial, however, has highlighted the need for careful and meticulous attention to the dosimetry in the radiation treatment plans as the 27 Gy in 5 fraction arm resulted in higher normal tissue effects compared with the 26 Gy in 5 fraction and 40 Gy in 15 fraction arms. At 5 years, the incidence of moderate or marked clinician‐assessed normal tissue effects in the breast or chest wall was 9.9% for the 40 Gy arm, 15.4% for the 27 Gy arm http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Medical Radiation Sciences Wiley

Extreme hypofractionation in radiation therapy for patients with early breast cancer: what is the optimal technique?

Journal of Medical Radiation Sciences , Volume 69 (2) – Jun 1, 2022
4 pages

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References (45)

Publisher
Wiley
Copyright
Copyright © 2022 Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology
ISSN
2051-3895
eISSN
2051-3909
DOI
10.1002/jmrs.590
Publisher site
See Article on Publisher Site

Abstract

Adjuvant external beam radiation therapy following breast‐conserving surgery is an integral component of treatment for patients diagnosed with early breast cancer. For many years, the established international standard has been the delivery of 25 daily fractions of 2 Gy encompassing the entire breast over 5 weeks. However, there is now established mature evidence in the form of 5 randomised clinical trials and a meta‐analysis1–6 for moderately hypofractionated radiation therapy of 15 to 16 fractions of 2.6 Gy. These have all demonstrated non‐inferior outcomes comparing the 3‐week regimen to the traditional 5–6‐week regimen in terms of safety and efficacy.Further to this, there is now emerging evidence supporting the use of an even more hypofractionated schedule of 5 fractions delivered over 1 week as shown by the FAST‐Forward trial.7 This three‐arm trial, however, has highlighted the need for careful and meticulous attention to the dosimetry in the radiation treatment plans as the 27 Gy in 5 fraction arm resulted in higher normal tissue effects compared with the 26 Gy in 5 fraction and 40 Gy in 15 fraction arms. At 5 years, the incidence of moderate or marked clinician‐assessed normal tissue effects in the breast or chest wall was 9.9% for the 40 Gy arm, 15.4% for the 27 Gy arm

Journal

Journal of Medical Radiation SciencesWiley

Published: Jun 1, 2022

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