Hypofractionated Adjuvant Whole Breast Radiotherapy: Progress and Prospects

Figures & data

Table I. Randomised clinical trials testing fraction size in whole breast external beam radiotherapy after local excision of early breast cancer. All trials used a standard arm delivering 50 Gy in 25 fractions over 5 weeks.

Trial	Test schedules*	Number patients	Breast conserving surgery (%)	Patients prescribed boost (%)	Median follow up (months)
START pilot 1986–98 [10,11]	39.0/13/5.0 (3.0)	1410	100	74.5	116
	42.9/13/5.0 (3.3)
Ontario 1993–96 [9,15]	42.5/16/3.2 (2.66)	1234	100	0	>132
START A 1999–02 [12]	39.0/13/5.0 (3.0)	2236	85	60.6^1	61
	41.6/13/5.0 (3.2)
START B 1999–01 [13]	40.0/15/3.0 (2.67)	2215	92	42.6^1	72

*Total dose (Gy), fraction number, treatment time (weeks) and fraction size (in brackets, Gy).

¹Breast conservation patients only.

Table II. Results of randomised clinical trials testing fraction size in whole breast external beam radiotherapy after local excision of early breast cancer. All trials used a standard arm delivering 50 Gy in 25 fractions over 5 weeks.

		5-year rates of:
Trial	Dose schedules*	Any change in breast appearance (%)	Good/excellent breast cosmesis (%)	Local tumour relapse (%)
START pilot 1986–98 [10,11]	50.0/25/5.0 (2.0)	35.4	–	12.1
	39.0/13/5.0 (3.0)	27.4	–	14.8
	42.9/13/5.0 (3.3)	42.3	–	9.6
Ontario 1993–96 [9,15]	50.0/25/5.0 (2.0)	–	79.2^1	3.2^2
	42.5/16/3.2 (2.66)	–	77.9^1	2.8^2
START A 1999–02 [12]	50.0/25/5.0 (2.0)	42.9	–	3.2
	39.0/13/5.0 (3.0)	32.1	–	4.6
	41.6/13/5.0 (3.2)	43.6	–	3.2
START B 1999–01 [13]	50.0/25/5.0 (2.0)	42.2	–	3.3
	40.0/15/3.0 (2.67)	36.5	–	2.0

*Total dose (Gy), fraction number, treatment time (weeks) and fraction size (in brackets, Gy).

¹71.3% and 69.8% at 10 years.

²6.7% and 6.2% at 10 years.

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