title: Comparison of hypofractionated and conventionally fractionated whole-breast irradiation for early breast cancer patients: a single-institute study of 1,098 patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of hypofractionated whole-breast irradiation (HF-WBI) compared with conventionally fractionated (CF) WBI.
  
  
  METHODS
  Patients with early breast cancer (stages 0-II and <3 positive lymph nodes) who had undergone breast-conserving surgery were eligible for the HF-WBI study. HF-WBI was administered at 43.2 Gy in 16 fractions over 3.2 weeks to the whole breast with an additional tumor-bed boost of 8.1 Gy in 3 fractions over 3 days for positive surgical margins or those <5 mm. CF-WBI was administered at 50 Gy in 25 fractions over 5 weeks to the whole breast with an additional tumor-bed boost of 16 Gy in 8 fractions over 1.4 weeks to 6 Gy in 3 fractions over 3 days, depending on margin status.
  
  
  RESULTS
  From April 1, 2006, to December 31, 2010, 717 patients were registered and 734 breasts were treated by HF-WBI. In the same period, 381 patients and 393 breasts who matched the study criteria chose CF-WBI, so the total number of patients in this comparison was 1,098. Grade 2 acute skin reactions were observed for 24 patients (3 %) in the HF-WBI group and 53 patients (14 %) in the CF-WBI (p < 0.001) group. The median follow-up period was 27 months. Two cases of intrabreast tumor recurrence were observed in each treatment group. Regional lymph node recurrence was observed in 1 HF-WBI patient and 2 CF-WBI patients.
  
  
  CONCLUSIONS
  HF-WBI is superior to CF-WBI in terms of acute skin reaction and has the same short-term efficacy.
authors.affiliation: Department of Radiology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan, kkarasaw@nirs.go.jp.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Karasawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kunogi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Hirai
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Hojo
authors.forename: Hisako
authors.initials: H
authors.lastname: Hirowatari
authors.forename: Hiromi
authors.initials: H
authors.lastname: Izawa
authors.forename: Kana
authors.initials: K
authors.lastname: Ito
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sasai
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kawashima
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Furuya
authors.forename: Satoru
authors.initials: S
authors.lastname: Sugimoto
authors.forename: Chie
authors.initials: C
authors.lastname: Kurokawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ozawa
authors.forename: Mitsue
authors.initials: M
authors.lastname: Saito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000556:secondary; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000556:secondary; D016022:Case-Control Studies; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D055815:Young Adult