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Hypofractionation – Breast cancer Radiotherapy
•
4 phase III studies whole breast irradiation:
Standard fractionation (25 x 2 Gy)
vs.
Hypofractionation
Canada: 16 x 2.66 Gy
UK: 15x 2.67 Gy / 13x 3, 3.2 or 3.3 Gy
•
Adjusted α/β 3.5
Breast cancer is more sensitive to fraction size:
No advantage in using ≤ 2 Gy fractions
•
n = 7,000 patients; median follow-up 10 years
Haviland Lancet Oncol 2013, Yarnold RO 2005, Whelan NEJM 2010,
START B Lancet 2008, START A Lancet Oncol 2008, Owen Lancet Oncol 2006