HYPO-FRACTIONATED RADIOTHERAPY: A TECHNICAL AND SOCIETAL INNOVATION IN THE TREATMENT OF BREAST CANCER

Adjuvant radiotherapy is a key element in the treatment of early breast cancer. In recent years, there has been a growing trend towards hypofractionated external radiotherapy regimens. Many have been shown to be equivalent to the standard regimen in terms of tumour control and cosmetic results, while improving patients quality of life. This paper provides an update on the main rationales for the use of hypofractionated radiotherapy in breast cancer, and reviews the bulk of the literature that has concluded that hypofractionated radiotherapy is effective and safe. We examine various hypofractionation regimens used in our Mohammed VI Centre for the treatment of cancers, aiming at care centred on the quality of life of our patients while improving their productivity at home and at work in order to facilitate their social reintegration in the face of the disease. We retrospectively analysed all patients treated in our department using the Fast Forward protocol and other hypofractionated regimens after the original publication was published and after an institutional consensus had been reached regarding the selection of patients with breast cancer without indication for lymph node irradiation. Patients were selected between January 2021 and December 2024 at the Mohammed VI Cancer Treatment Centre. The median age of the patients was 53 years. Invasive ductal carcinoma was the most common histological type (90%). Lumpectomy was performed in 19 patients. The preferred site was the left breast. All patients were treated using modern conformal techniques with coverage of the predicted target volume of between 95 and 100%. Treatment toxicity was assessed in the short, medium and long term in accordance with world standards. Today, 70% of our patients are still active in their social and professional lives, and 80% of them are mothers. At present, we are joining the growing body of scientific evidence in making hypo-fractionated radiotherapy the therapeutic standard for the irradiation of early breast cancer. With fewer fractions of treatment and more fractions of life for our patients, hypofractionated radiotherapy is an example of a care pathway that aims to deploy effective strategies for de-escalating the therapeutic burden and reducing the after-effects of cancer treatment.