PURPOSE OF REVIEW It is now accepted that prostate cancer has a low alpha/beta ratio, establishing a strong basis for hypofractionation of prostate radiotherapy. This review focuses on the rationale for hypofractionation and presents the evidence base for establishing moderate hypofractionation for localised disease as the new standard of care. The emerging evidence for extreme hypofractionatio...

Traditionally, as a standard dose fractionation schedule, adjuvant radiotherapy for breast cancer has been performed using prescribed doses of 46–50 Gy divided into daily fractions 1.8–2 Gy. Overall, treatment took 5 weeks. In the 1990s, schedules higher (2.5–3 Gy), smaller number (hypofractionation), and reduced overall started in context clinical trials. First results revealed an equivalent c...

BACKGROUND Several studies have reported a low α to β ratio for prostate cancer, suggesting that hypofractionation could enhance the biological tumour dose without increasing genitourinary and gastrointestinal toxicity. We tested this theory in the phase 3 HYPRO trial for patients with intermediate-risk and high-risk prostate cancer. We have previously reported acute incidence of genitourinary ...

SUMMARY OBJECTIVE: Several prospective randomized trials have shown that hypofractionation has the same efficacy and safety as conventional fractionation in treatment of localized prostate cancer. There are many benefits hypofractionation, including a more convenient schedule for patients better use resources, which is especially important low- middle-income countries like Brasil. Based on thes...

IMPORTANCE Based on randomized evidence, expert guidelines in 2011 endorsed shorter, hypofractionated whole breast irradiation (WBI) for selected patients with early-stage breast cancer and permitted hypofractionated WBI for other patients. OBJECTIVES To examine the uptake and costs of hypofractionated WBI among commercially insured patients in the United States. DESIGN, SETTING, AND PARTIC...

We consider the fractionation problem in radiation therapy. Tumor sites in which the dose-limiting organ at risk (OAR) receives a substantially lower dose than the tumor, bear potential for hypofractionation even if the α/β-ratio of the tumor is larger than the α/β-ratio of the OAR. In this work, we analyze the interdependence of the optimal fractionation scheme and the spatial dose distributio...

Hypofractionation has been a recurring issue during the near century-long history of radiation oncology. Coutard first introduced protracted dose-fraction regimens that uniquely allowed for the control of “deep” tumors. Subsequent studies have consistently shown that hypofractionation leads to an increase in complication rates and a paradoxical decrease in cure rates. There have, nonetheless, b...

Hypofractionation has been a recurring issue during the near century-long history of radiation oncology. Coutard first introduced protracted dose-fraction regimens that uniquely allowed for the control of "deep" tumors. Subsequent studies have consistently shown that hypofractionation leads to an increase in complication rates and a paradoxical decrease in cure rates. There have, nonetheless, b...