Hypofractionated radiotherapy for breast cancer: how to evaluate chronic toxicity and cosmesis?

Adjuvant irradiation constitutes an important component in the postoperative treatment of breast cancer, reaching as far as 25–30% of workload in radiotherapy departments. Some approaches to reduce delays and optimize available resources include accelerated schedules of daily doses slightly superior to standard ones (1). Several trials had utilized altered fractionations ranging from 2.5 Gy in 16 fractions to 3.3 Gy in 13 fractions (2,3), showing almost an equivalent safety and effectiveness compared to standard fractionation.