title: Hypofractionated radiotherapy after conservative surgery for breast cancer: analysis of acute and late toxicity.
abstract: BACKGROUND
  A variety of hypofractionated radiotherapy schedules has been proposed after breast conserving surgery in the attempt to shorten the overall treatment time. The aim of the present study is to assess acute and late toxicity of using daily fractionation of 2.25 Gy to a total dose of 45 Gy to the whole breast in a mono-institutional series.
  
  
  METHODS
  Eighty-five women with early breast cancer were assigned to receive 45 Gy followed by a boost to the tumour bed. Early and late toxicity were scored according to the Radiation Therapy Oncology Group criteria. For comparison, a group of 70 patients with similar characteristics and treated with conventional fractionation of 2 Gy to a total dose of 50 Gy in 25 fractions followed by a boost, was retrospectively selected.
  
  
  RESULTS
  Overall median treatment duration was 29 days for hypofractionated radiotherapy and 37 days for conventional radiotherapy. Early reactions were observed in 72/85 (85%) patients treated with hypofractionation and in 67/70 (96%) patients treated with conventional fractionation (p = 0.01). Late toxicity was observed in 8 patients (10%) in the hypofractionation group and in 10 patients (15%) in the conventional fractionation group, respectively (p = 0.4).
  
  
  CONCLUSIONS
  The hypofractionated schedule delivering 45 Gy in 20 fractions shortened the overall treatment time by 1 week with a reduction of skin acute toxicity and no increase of late effects compared to the conventional fractionation. Our results support the implementation of hypofractionated schedules in clinical practice.
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Deantonio
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Gambaro
authors.forename: Debora
authors.initials: D
authors.lastname: Beldì
authors.forename: Laura
authors.initials: L
authors.lastname: Masini
authors.forename: Sara
authors.initials: S
authors.lastname: Tunesi
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnani
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002277:Carcinoma / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D017564:Radiation Pneumonitis / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies