Canadian Trial

• A multi-institution, prospective randomized trial:
  • From participating Cancer Care Ontario centers:
    • Was performed from 1993 to 1996
• The aim of the study sought to determine:
  • Whether accelerated, hypofractionation whole-breast irradiation (WBI) was as effective as the traditional 5-week schedule
• Included in the study were women:
  • Who received (BCS) for invasive breast cancer with clear surgical margins and negative axillary nodes
• Participants were randomly assigned:
  • To receive WBI either at the standard dose:
    • Of 50.0 Gy in 25 fractions over 35 days (control group), or
  • At a dose of 42.5 Gy in 16 fractions over 22 days (hypofractionated-radiation group)
• The control group included 612 patients and the hypofractionation group had 622 patients
• Results from this study:
  • Indicated that the Canadian regimen:
    • Was not inferior to the standard 5-week treatment regimen for women who received BCS for invasive breast cancer with clear surgical margins and negative axillary nodes
  • The risk of local recurrence at 10 years was:
    • 6.7% in the control group and 6.2% in the hypofractionated group
  • Cosmesis at 10 years was found to be:
    • Comparable between the two groups:
      • With good or excellent outcomes:
        • For 71.3% of women in the control group and 69.8% in the hypofractionated-radiation group
  • There was also no difference between the two groups in:
    • OS and no increase in cardiac-related deaths was seen in the hypofractionated group

REFERENCES

1. Whelan TJ, Pignol J-P, Levine MN, et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med. 2010;362:513-520.

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