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Irradiation hypofractionnée dans le cancer du sein : pour ou contre ?

Irradiation hypofractionnée dans le cancer du sein : pour ou contre ?,10.1016/j.canrad.2011.07.235,Cancer Radiotherapie,B. Cutuli,A. Fourquet

Irradiation hypofractionnée dans le cancer du sein : pour ou contre ?   (Citations: 1)
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The continuous increase of breast cancer (BC) incidence, the logistic constraints of the protracted standard 5-week radiations regimen have led to test short hypofractionated whole breast radiation therapy schemes. Three prospective randomized trials and a pilot trial have been published. Large numbers of patients were included, with follow-up duration ranging from 5 to 12 years. The conclusions of these trials were similar, showing local control and toxicity equivalent to those of the standard regimen, and supporting the use of three schemes: 42.5Gy/16 fractions/3 weeks, 40Gy/15 fractions/3 weeks or 41.6Gy/13 fractions/5 weeks. However, the patients in these trials had favourable prognostic factors, were treated to the breast only and the boost dose, when indicated, was delivered with a standard fractionation. Hypofractionated treatment can only be recommended in patients treated to the breast only, without nodal involvement, with grade<3 tumours and who are not candidate to chemotherapy. If a boost is to be given, a standard fractionation should be used. Particular care should be taken to avoid heterogeneities leading to high fractional doses to organs at risk (lung and heart).
Journal: Cancer Radiotherapie - CANCER RADIOTHER , vol. 15, no. 6, pp. 445-449, 2011
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