Canadian Trial – Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer

• A multi-institution, prospective randomized trial:
  • From participating Cancer Care Ontario centers was performed from 1993 to 1996
• The study sought to determine whether:
  • Accelerated hypofractionated whole-breast irradiation (WBI) was as effective as conventional 5-week fractionation
• Included in the study were women who received:
  • Breast-conserving surgery (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 2 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 2 groups in overall survival and no increase in cardiac-related deaths was seen in the hypofractionated group
• References
  • Whelan TJ, Pignol J-P, Levine MN, Julian JA, MacKenzie R, Parpia S, et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med. 2010;362(6):513-520

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