N. Engl. J. Med. 2010-02-11
Long-term results of hypofractionated radiation therapy for breast cancer.
ABSTRACT
BACKGROUND
The optimal fractionation schedule for whole-breast irradiation after breast-conserving 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% confidence 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.)
Related Questions
What about lobular carcinoma?
New comment by Radiation Oncologist at Meadowview Regional Medical Center ( March 23, 2018)
Thanks, @Michael G. Chang
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New answer by Radiation Oncologist at University of Texas MD Anderson Cancer Center (May 2, 2015)
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New answer by Radiation Oncologist at Rutgers Robert Wood Johnson Medical School (March 14, 2018)
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New answer by Radiation Oncologist at New York University School of Medicine (November 24, 2016)
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New answer by Radiation Oncologist at Rutgers Robert Wood Johnson Medical School (March 15, 2018)
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Do you boost when employing this regimen?
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This metric is antiquated and based upon the OCOG (Whelan et al., PMID 20147717) trial comparing 50 Gy to 42 Gy for whole breast RT. For this trial performed in the mid-...
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It would be difficult not to recommend at this time.HypoG-01 had broad criteria and did not show any differences in outcomes in terms of disease control or toxicity between 40...