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START Trial B –

40Gy in 15# of 2.67Gy was as effective in terms of tumour control &

adverse effects as 50Gy in 25# of 2Gy.

FAST trial

28.5Gy in 5# of 5.7Gy appears equivalent to 50Gy/25F in terms of

change in breast appearance at 2 years and late adverse effects

in breast at a median of 3.1 years.

This is unlikely to be the limit of hypofractionation – how far can

we go?