European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer.
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Authors
Meattini, Icro
Becherini, Carlotta
Boersma, Liesbeth
Kaidar-Person, Orit
Marta, Gustavo Nader
Montero, Angel
Offersen, Birgitte Vrou
Aznar, Marianne C
Belka, Claus
Brunt, Adrian Murray
Dicuonzo, Samantha
Franco, Pierfrancesco
Krause, Mechthild
MacKenzie, Mairead
Marinko, Tanja
Marrazzo, Livia
Ratosa, Ivica
Scholten, Astrid
Senkus, Elżbieta
Stobart, Hilary
Poortmans, Philip
Coles, Charlotte E
Publication Date
2022-01Journal Title
Lancet Oncol
ISSN
1470-2045
Publisher
Elsevier BV
Volume
23
Issue
1
Pages
e21-e31
Type
Article
This Version
AM
Metadata
Show full item recordCitation
Meattini, I., Becherini, C., Boersma, L., Kaidar-Person, O., Marta, G. N., Montero, A., Offersen, B. V., et al. (2022). European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer.. Lancet Oncol, 23 (1), e21-e31. https://doi.org/10.1016/S1470-2045(21)00539-8
Abstract
High-quality randomised clinical trials testing moderately fractionated breast radiotherapy have clearly shown that local control and survival is at least as effective as with 2 Gy daily fractions with similar or reduced normal tissue toxicity. Fewer treatment visits are welcomed by patients and their families, and reduced fractions produce substantial savings for health-care systems. Implementation of hypofractionation, however, has moved at a slow pace. The oncology community have now reached an inflection point created by new evidence from the FAST-Forward five-fraction randomised trial and catalysed by the need for the global radiation oncology community to unite during the COVID-19 pandemic and rapidly rethink hypofractionation implementation. The aim of this paper is to support equity of access for all patients to receive evidence-based breast external beam radiotherapy and to facilitate the translation of new evidence into routine daily practice. The results from this European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus state that moderately hypofractionated radiotherapy can be offered to any patient for whole breast, chest wall (with or without reconstruction), and nodal volumes. Ultrafractionation (five fractions) can also be offered for non-nodal breast or chest wall (without reconstruction) radiotherapy either as standard of care or within a randomised trial or prospective cohort. The consensus is timely; not only is it a pragmatic framework for radiation oncologists, but it provides a measured proposal for the path forward to influence policy makers and empower patients to ensure equity of access to evidence-based radiotherapy.
Identifiers
External DOI: https://doi.org/10.1016/S1470-2045(21)00539-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/331959
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/
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