Dr. Wright on the Benefit of Moderate Hypofractionation in Early-Stage Breast Cancer

Jean Wright, MD, director of the Breast Cancer Program, Department of Radiation Oncology and Molecular Radiation Sciences, associate professor of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, discusses the benefit of moderate hypofractionation in patients for adjuvant radiotherapy in patients with early-stage breast cancer.

At the 40th Annual Miami Breast Cancer Conference®, Wright and Atif Khan, MD, MS, of Memorial Sloan Kettering Cancer Center, debated the use of 5 fractions or 15 fractions for adjuvant radiotherapy in early-stage breast cancer. In the debate, Wright argued for that 15 fractions should be used for the majority of patients in this setting. This approach is know as moderate hypofractionation. Two large, randomized studies conducted globally now have long-term follow-up of at least 10 years, which compared moderate hypofractionation to what was previously the standard radiation therapy of 5 weeks or longer, Wright expands.

Those studies showed that moderate hypofractionation is equally efficacious compared with the traditional form of radiotherapy, Wright notes. Moderate hypofractionation was associated with lower toxicity, both in the acute timeframe during the administration of radiotherapy and the ensuing months, as well as late toxicities that can emerge long after radiation therapy is completed, Wright continues. These robust datasets support the use of moderate hypofractionation, Wright adds.

Additionally, the ASTRO Whole Breast Irradiation Guideline endorses moderate hypofractionation as the preferred strategy in this patient population, Wright adds. These guidelines are based on those randomized trials, as well as a wide range of institutional datasets and consortiums that have further validated this hypothesis in a broad range of patients, Wright concludes.