Randomised controlled trials on radiation dose fractionation in breast cancer: systematic review and meta-analysis with emphasis on side effects and cosmesis

In a systematic literature review and publication-based meta-analysis of RCTs, moderately hypofractionated post-operative radiotherapy (in effect meaning the most commonly utilised 40Gy in 15 fractions over three weeks recommended routinely in the UK) showed improved cosmesis, quality of life and safety compared to 5-6 week regimens of around 50Gy (often termed ‘conventionally fractionated’). Oncological outcomes were equivalent.

This review provides strong support for the use of less expensive, less toxic and equally effective hypofractionated post-operative radiotherapy regimens.