by Gustavo Nader Marta, Rachel Riera, Rafael Leite Pacheco,
Ana Luiza Cabrera Martimbianco, Icro Meattini, Orit Kaidar-Person, Philip
Poortmans
The Breast: Published:February 02, 2022
Introduction
We provide a critical assessment regarding current evidence
for the use of moderately hypofractionated irradiation for patients with breast
cancer. The aim of the study was to summarize the available evidence regarding
outcomes after moderately hypofractionated compared with conventional radiation
doses in the post-operative treatment of patients with breast cancer.
Material and methods
The Cochrane Central Register of Controlled Trials, MEDLINE,
EMBASE and LILACS databases were searched until March 25, 2021. All randomized
phase 3 clinical trials that compared moderately hypofractionated with
conventional radiation doses in the post-operative treatment of patients with
breast cancer were selected. This review followed the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) Statement.
Results
Eight clinical trials satisfied the eligibility criteria and
were the focus of the analysis. A total of 12,139 breast cancer patients was
randomly assigned for moderately hypofractionated compared with conventional
irradiation. Meta-analysis of the trials regarding local recurrence,
loco-regional recurrence, disease-free survival, and overall survival outcomes
did not demonstrate any significant difference between moderately
hypofractionated irradiation and conventional radiation doses groups. The rate
of severe side effects was low in both groups; acute and late side effects and
cosmesis were similar or even tended to be lower after moderately
hypofractionated than after conventional irradiation.
Conclusions
Moderately hypofractionated is at least as effective and
safe as conventional radiation irradiation regimens and should be considered as
a treatment option for most, if not all, breast cancer patients.
