Comparison of hypofractionated and conventionally fractionated whole-breast irradiation for early breast cancer patients: a single-institute study of 1,098 patients

Abstract

HF-WBI is superior to CF-WBI in terms of acute skin reaction and has the same short-term efficacy.

Systematic review and meta-analysis comparing hypofractionated with conventional fraction radiotherapy in treatment of early breast cancer

“…Treatment costs for CFRT were US$5405 in patients with negative margins and US$5649 in patients with positive margins. Thus, treatment costs were almost one-third lower for HFRT for all patients [16]. Other reviews or articles reported similar results.…”

“…In the 2.5e3.0 Gy per fraction subgroup, 9 studies with 9011 patients were included in the meta-analysis [10e13, 16,24,25,28,38,39], pooled RR indicated that HFRT were with comparable local regional recurrence rate in comparison with CFRT [RR ¼ 1.03, 95% CI (0.87, 1.23), P ¼ 0.72]. In the 3.01e3.33 Gy per fraction subgroup, meta-analysis of 2 RCTs with 2435 patients showed that there was no significant difference between HFRT and CFRT [RR ¼ 0.89, 95% CI (0.67, 1.18), P ¼ 0.41] [11,13].…”

“…In the 2.5e3.0 Gy per fraction subgroup, seven trials with 2170 patients were included in metaanalysis [16,23,26,32,33,36,39], pooled estimate indicated that HFRT significantly decreased grade 2/3 acute skin reactions compared with CFRT [RR ¼ 0.50, 95% CI (0.28, 0.89), P ¼ 0.02]. In the 5.0e6.5 Gy per fraction subgroup, 2 studies with total of 1105 patients were included in the meta-analysis [14,39], the result manifested that HFRT significantly decreased grade 2/3 acute skin reactions compared with CFRT [RR ¼ 0.26, 95% CI (0.16, 0.40), P < 0.00001].…”

“…In the 2.5e3.0 Gy per fraction subgroup, pooled estimate of 5 studies with 5303 patients indicated that there was no significant difference between HFRT and CFRT [RR ¼ 1.01, 95% CI (0.59, 1.74), P ¼ 0.96] [12,13,16,19,36]. In the 3.01e3.33 Gy per fraction subgroup, one RCT with 1499 patients investigated symptomatic radiation pneumonitis, there was no significant difference between two arms [RR ¼ 1.20, 95% CI (0.37, 3.91), P ¼ 0.76] [13].…”

Role of hypofractionated radiotherapy in breast locoregional radiation

“…These trials, with median follow-up times of 9 to 12 years, have demonstrated that hypofractionated radiotherapy is associated with equivalent local control compared to standard fractionation and a similar or lower rates of late effects on breast and also in the surrounding tissue as lungs and heart [5][6][7]. Others studies have reported lower rates of acute adverse effects from hypofractionated radiotherapy [8,9]. The UK National Institute for Clinical Excellence (NICE) guidelines have recommended hypofractionated dose of 40 Gy in 15 fractions over 3 weeks for adjuvant radiotherapy to the breast only or to the breast plus regional nodes for women with early breast cancer [10,11].…”