A shorter course of hypofractionated whole-breast irradiation may be substituted for treatment with conventional fractions following breast-conserving surgery in selected patients with early-stage breast cancer.
The new recommendation comes from an evidence-based guideline published by the American Society for Radiation Oncology (Int. J. Radiat. Oncol. Biol. Phys. [doi:10.1016/j.ijrobp.2010.04.042]).
The guideline task force concluded that hypofractionated whole-breast irradiation is just as effective as conventional fractions for women who are at least 50 years old at diagnosis and meet all of the following criteria:
▸ The pathologic stage is T1-2N0, and the patient has been treated with breast-conserving surgery.
▸ The patient has not been treated with systemic chemotherapy.
▸ The minimum dose is no less than 93%, and the maximum is no greater than 107% of the prescription dose within the breast along the central axis.
Hypofractionated whole-breast irradiation uses a higher radiation dose for each treatment, but fewer total treatments are necessary. Typically, patients can finish treatment in 4 weeks or less with hypofractionated radiation therapy.
This can help to minimize some of the inconvenience and expense associated with conventionally fractioned whole-breast irradiation, which involves daily treatments for up to 7 weeks.
The guideline authors reported that they have no conflicts of interest.