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Fractionation for whole breast irradiation: An American Society for Radiation Oncology (ASTRO) evidence-based guideline (2011)

Authors: Benjamin D. Smith, MD, Søren M. Bentzen, PhD, DSc, Candace R. Correa, MD, Carol A. Hahn, MD,  Patricia H. Hardenbergh, MD, Geoffrey S. Ibbott, PhD, Beryl McCormick, MD, FACR, Julie R. McQueen, CHES, RHEd, Lori J. Pierce, MD, Simon N. Powell, MD, PhD, Abram Recht, MD, Alphonse G. Taghian, MD, PhD, Frank A. Vicini, MD, FACR, Julia R. White, MD,  and Bruce G. Haffty, MD  

This guideline provides guidance for patients and physicians regarding the appropriate use of hypofractionated whole breast irradiation (HF-WBI) as adjuvant treatment of breast cancer following breast conserving surgery. The clinical radiobiology of breast cancer is also explored. This paper investigates the literature regarding which patients obtain equivalent results from HF-WBI and conventionally fractionated whole breast irradiation (CF-WBI); the role of a tumor bed radiation boost in HF-WBI patients; appropriate regimens for HF-WBI and tumor bed boost; characteristics of an acceptable radiotherapy plan for HF-WBI patients; and breast cancer radiobiology insights from clinical trials comparing CF-WBI and HF-WBI. Data was sufficient to support the use of HF-WBI for early stage breast cancer patients age 50 years or older, who had disease stage pT1-2 pN0, did not receive chemotherapy and were treated with a radiation dose homogeneity within ±7 percent in the central axis plane. Data was considered insufficient to make a judgment on the use of HF-WBI in other types of patients.

Read the guideline.

Content last updated 1/10/2014
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