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Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer

Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer,10.1056/NEJMoa0906260,New England Journal of Medicine,Timothy J. Whelan,Jean

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Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer   (Citations: 30)
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Timothy J. Whelan, Jean-Philippe Pignol, Mark N. Levine, Jim A. Julian, Robert MacKenzie, Sameer Parpia, Wendy Shelley, Laval Grimard, Julie Bowen, Himu Lukka, Francisco Perera, Anthony Fyleshttp://academic.research.microsoft.com/io.ashx?type=5&id=10508762&selfId1=0&selfId2=0&maxNumber=12&query=
BACKGROUND The optimal fractionation schedule for whole-breast irradiation after breast-con- serving surgery is unknown. METHODS We conducted a study to determine whether a hypofractionated 3-week schedule of whole-breast irradiation is as effective as a 5-week schedule. Women with invasive breast cancer who had undergone breast-conserving surgery and in whom resection margins were clear and axillary lymph nodes were negative were randomly assigned to receive whole-breast irradiation either at a standard dose of 50.0 Gy in 25 fractions over a period of 35 days (the control group) or at a dose of 42.5 Gy in 16 fractions over a period of 22 days (the hypofractionated-radiation group). RESULTS The risk of local recurrence at 10 years was 6.7% among the 612 women assigned to standard irradiation as compared with 6.2% among the 622 women assigned to the hypofractionated regimen (absolute difference, 0.5 percentage points; 95% con- fidence interval (CI), −2.5 to 3.5). At 10 years, 71.3% of women in the control group as compared with 69.8% of the women in the hypofractionated-radiation group had a good or excellent cosmetic outcome (absolute difference, 1.5 percentage points; 95% CI, −6.9 to 9.8). CONCLUSIONS Ten years after treatment, accelerated, hypofractionated whole-breast irradiation was not inferior to standard radiation treatment in women who had undergone breast-conserving surgery for invasive breast cancer with clear surgical margins and negative axillary nodes. (ClinicalTrials.gov number, NCT00156052.)
Journal: New England Journal of Medicine - N ENGL J MED , vol. 362, no. 6, pp. 513-520, 2010
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    • ...Recent randomized trials have confirmed that hypofractioned whole-breast irradiation is equivalent to more conventional whole-breast irradiation with respect to local recurrence and cosmetic outcome [6-8]...
    • ...Patients with large breasts (as defined by a cup size separation of greater than 25 cm, that is, the breast measured more than 25 cm left to right at its widest part) were also excluded [8,9]...
    • ...They conclude that the more convenient 22-day fractionation schedule appears to be an acceptable alternative to the 35-day schedule [8]...
    • ...Based on the results of some important randomized trials [6-8], from February 2007 we began treating early stage breast cancer patients using a hypofractionated schedule of 46 Gy prescribed to the ICRU 50 reference point dose and delivered in 20 fractions, 4 times a week for 5 weeks...

    Marina Guenzi, et al. A biologically competitive 21 days hypofractionation scheme with weekl...

    • ...whole breast radiotherapy and have shown good results in breast cancer patients with non-metastatic, node-negative disease [56,57]...

    Romuald Le Scodan, et al. Exclusive and adjuvant radiotherapy in breast cancer patients with syn...

    • ...

      In an effort to decrease radiation treatment times, patient inconvenience and costs, and to improve efficiency in the utilization of resources, more rapid courses of radiation have been evaluated over the past 10 years...

    Bruce G. Haffty. RadiotherapyHypofractionation for breast cancer—clinical implications

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