Editorial
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World J Radiol. Jun 28, 2010; 2(6): 197-202
Published online Jun 28, 2010. doi: 10.4329/wjr.v2.i6.197
Hypofractionated radiotherapy in the treatment of early breast cancer
George Plataniotis
George Plataniotis, Consultant and Senior Lecturer of Clinical Oncology, Department of Oncology, Aberdeen Royal Infirmary Foresterhill, AB25 2ZN, Aberdeen, United Kingdom
Author contributions: Plataniotis G contributed all to the paper.
Correspondence to: George Plataniotis, MD, PhD, Consultant and Senior Lecturer of Clinical Oncology, Department of Oncology, Aberdeen Royal Infirmary Foresterhill, AB25 2ZN, Aberdeen, United Kingdom. george.plataniotis@nhs.net
Telephone: +44-1224-553483 Fax: +44-1224-554183
Received: April 12, 2010
Revised: May 21, 2010
Accepted: May 28, 2010
Published online: June 28, 2010
Abstract

Radiotherapy (RT) after tumorectomy in early breast cancer patients is an established treatment modality which conventionally takes 6-7 wk to complete. Shorter RT schedules have been tested in large multicentre randomized trials and have shown equivalent results to that of standard RT (50 Gy in 25 fractions) in terms of local tumor control, patient survival and late post-radiation effects. Some of those trials have now completed 10 years of follow-up with encouraging results for treatments of 3-4 wk and a total RT dose to the breast of 40-42.5 Gy with or without boost. A reduction of 50% in treatment time makes those RT schedules attractive for both patients and health care providers and would have a significant impact on daily RT practice around the world, as it would accelerate patient turnover and save health care resources. However, in hypofractionated RT, a higher (than the conventional 1.8-2 Gy) dose per fraction is given and should be managed with caution as it could result in a higher rate of late post-radiation effects in breast, heart, lungs and the brachial plexus. It is therefore advisable that both possible dose inhomogeneity and normal tissue protection should be taken into account and the appropriate technology such as three-dimensional/intensity modulated radiation therapy employed in clinical practice, when hypofractionation is used.

Keywords: Breast conservation, Early breast cancer, Hypofractionation, Radiotherapy