Radiation Therapy for Breast Cancer: Are Fewer Fractions Better?

British trial results favored fewer fractions, higher doses per fraction, and fewer weeks of radiation therapy for early breast cancer; longer follow-up is needed.

Breast-conserving surgery (typically lumpectomy followed by radiation therapy [XRT]) is standard care for most women with early breast cancer. Conventional XRT entails a total dose of 50 Gy administered in 25 2-Gy fractions over the course of 5 weeks. XRT involving fewer, but higher-dose, fractions is known as hypofractionation therapy. In two parallel U.K. Standardisation of Breast Radiotherapy (START) trials, investigators randomized women (mean age, 57) who had undergone breast-conserving surgery or mastectomy with clear tumor margins to conventional XRT or to XRT entailing 13 fractions (3.0 or 3.2 Gy/fraction) over 5 weeks (START A, 2236 women) or 15 fractions (2.7 Gy/fraction) over 3 weeks (START B, 2215 women).

In START A, 85% of parti…

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Radiation Therapy for Breast Cancer: Are Fewer Fractions Better?

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Reviewing Author