Jacobs Journal of Radiation Oncology

Hypofractionation should be the standard of care for breast cancer radiotherapy

Published on: 2018-12-20


Clinical adoption of hypofractionation for breast cancer radiotherapy has been sub-optimal, despite sound rationale and robust level I evidence. Radiobiological modelling, primarily spearheaded by the development of Linear Quadratic model, has shown that the biological effect of radiation is a function of total dose and fraction size, and that the inherent radiation sensitivity or α ⁄ β ratio of the tissue in question will modify the effect of fraction size. This model suggests that if the α ⁄ β ratio of the tumor is same or less than that of relevant normal tissue, then a larger dose per fraction with a modest decrease in total dose may be equally or potentially more effective than the conventionally fractionated radiotherapy.