title: [Hypofractionated whole breast irradiation: Pro and cons].
abstract: The continuous increase of breast cancer (BC) incidence, the logistic constraints of the protracted standard 5-week radiations regimen have led to test short hypofractionated whole breast radiation therapy schemes. Three prospective randomized trials and a pilot trial have been published. Large numbers of patients were included, with follow-up duration ranging from 5 to 12 years. The conclusions of these trials were similar, showing local control and toxicity equivalent to those of the standard regimen, and supporting the use of three schemes: 42.5 Gy/16 fractions/3 weeks, 40 Gy/15 fractions/3 weeks or 41.6 Gy/13 fractions/5 weeks. However, the patients in these trials had favourable prognostic factors, were treated to the breast only and the boost dose, when indicated, was delivered with a standard fractionation. Hypofractionated treatment can only be recommended in patients treated to the breast only, without nodal involvement, with grade<3 tumours and who are not candidate to chemotherapy. If a boost is to be given, a standard fractionation should be used. Particular care should be taken to avoid heterogeneities leading to high fractional doses to organs at risk (lung and heart).
authors: Institut du cancer Courlancy, 38, rue de Courlancy, 51100 Reims, France. bcutuli@iccreims.fr
authors: B
authors: B
authors: Cutuli
authors: A
authors: A
authors: Fourquet
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D058958:Organs at Risk; D018579:Patient Selection; D010865:Pilot Projects; D011446:Prospective Studies; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data