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A review on radiotherapy hypofractionation schedules for breast cancer treatment

Published online by Cambridge University Press:  23 November 2010

Christina Armpilia ,
Christos Antypas ,
Anna Zygogianni ,
Myrsini Balafouta ,
Panagiotis Sandilos  and
John Kouvaris
Christina Armpilia*
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
Christos Antypas
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
Anna Zygogianni
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
Myrsini Balafouta
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
Panagiotis Sandilos
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
John Kouvaris
Affiliation:
Department of Radiotherapy, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece
*
Correspondence to: Christina Armpilia, Aretaieion Hospital, Medical School, University of Athens, 76 Vas Sophias av., 11528, Athens, Greece. E-mail: charbilia@med.uoa.gr
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Abstract

Radiation therapy is an integral part of management in breast carcinoma treatment. Standard curative schedules of radiotherapy to the breast deliver 25 fractions of 2.0 Gy per day over 5–6 weeks. Considerable recent literature suggests that hypo-fractionation may be advisory in breast cancer. The use of fewer fractions of more than 2 Gy per day (hypo-fractionation) is based on data suggesting that breast carcinoma is more sensitive to fraction size than squamous carcinomas and therefore could have similar fractionation sensitivity to the dose-limiting healthy tissues, including skin, subcutaneous tissues, muscle and ribs. In this article, a review of published studies and currently ongoing trials, which may provide evidence for the use of hypo-fractionated radiotherapy in breast cancer patients, is presented. Also, for all these different hypo-fractionation regimens found in literature, biologically effective dose (BED) values are calculated and compared. Data from studies and randomised trials seem to support the concept that modest hypo-fractionation can be used to treat the whole breast after breast-conserving surgery with similar rates of local control and radiation morbidity as seen with conventional fractionation.

Keywords

breast cancer radiotherapyhypo-fractionationbreast radiobiology
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 10 , Issue 3 , September 2011 , pp. 201 - 208
Copyright
Copyright © Cambridge University Press 2011

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