Hypofractionation for postoperative breast cancer radiotherapy: is acute toxicity a limiting factor?

Whole-breast radiotherapy (RT) after conservative surgery in women with early breast cancer is the standard of care, providing a reduction of local recurrence and breast cancer mortality (1). In order to facilitate the access to RT centers, to optimize the allocation of RT resources, and to preserve the patient quality of life, the scientific community has investigated the efficacy and toxicity of abbreviated courses of postoperative breast RT by using a radiobiologically-equivalent total dose with hypofractionated schedules in randomized controlled trials as well as in several prospective and retrospective studies (2-5).