Hypofractionation improves convenience and may reduce acute pain, fatigue, and the extent to which patients are bothered by dermatitis in patients undergoing whole-breast radiotherapy for breast cancer, a new study published online ahead of print in JAMA Oncology.

For the study, researchers sought to analyze the impact of varying radiation fractionation schemes on acute toxic effects and patient-reported outcomes in women with breast cancer undergoing whole-breast radiotherapy.

Researchers evaluated data from 2,309 patients who received adjuvant whole-breast radiotherapy after lumpectomy for unilateral breast cancer between October 2011 and June 2014. All patients had received a comprehensive physician toxicity evaluation within 1 week of finishing treatment and at least 1 weekly evaluation during treatment.

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Results showed that patients who received conventional fractionation experienced significantly higher maximum physician-assessed skin reaction (P<0.001), self-reported pain (P=0.003), burning/stinging bother (P=0.002), pain bother (P=0.001), swelling bother (P=0.03), and fatigue (P=0.02).

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However, patients who received conventional fractionated whole-breast radiotherapy experienced slight greater absence of skin induration during follow-up (P=0.02).

The study demonstrated no significant differences in any other measured outcomes during the 6 months of follow-up.


  1. Jagsi R, Griffith KA, Boike TP, et al. Differences in the acute toxic effects of breast radiotherapy by fractionation schedule: comparative analysis of physician-assessed and patient-reported outcomes in a large multicenter cohort. JAMA Oncol. 2015. [epub ahead of print]. doi: 10.1001/jamaoncol.2015.2590.