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Hypofractionated whole breast radiotherapy: current perspectives

Authors Koulis T, Phan T, Olivotto I

Received 12 June 2015

Accepted for publication 21 August 2015

Published 27 October 2015 Volume 2015:7 Pages 363—370


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Pranela Rameshwar

Theodora A Koulis, Tien Phan, Ivo A Olivotto

Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada

Abstract: Adjuvant radiotherapy (RT) is an important part of breast cancer management but the dose and fractionation schedules used are variable. A total of 50 Gy in 25 daily fractions delivered over 5 weeks is often considered the "standard" adjuvant RT prescription. Hypofractionated regimes such as 42.5 Gy in 16 daily fractions or 40 Gy in 15 daily fractions following breast-conserving surgery have proven to be equally effective and achieve similar or better cosmetic and normal tissue outcomes for both invasive and in situ diseases and when treating the regional nodes. Hypofractionation is more convenient for patients and less costly. However, certain patients at higher risk of RT late effects may benefit from a less intense, even more extended fractionation schedule. This review describes the indications for whole breast hypofractionated adjuvant RT for patients with breast cancer following breast-conserving surgery and proposes that hypofractionation should be the new "standard" for adjuvant breast cancer RT.

Keywords: fractionation, breast cancer, cosmesis, radiotherapy

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