What is hypofractionation?
Hypofractionation is a treatment for breast cancer, which involves a reduction of the irradiation time from 7-8 weeks of classical treatment to about 3-4 weeks. This treatment achieves
- A decrease in the waiting time at the start of treatment.
- A decrease in the total cost of treatment by using fewer fractions.
- The patient will have to go to the hospital fewer times for treatment.
From the radiobiological approach, the relationship between the total dose administered, the dose per fraction and locoregional tumor control in breast cancer has been studied since the 20th century. In conclusion, this has allowed, together with hypofractionation in tumors with a low coefficient, the development of accelerated schemes in the treatment of breast cancer. There is clinical and theoretical evidence that a small increase in dose associated with a decrease in the total dose of irradiation administered is effective in radiation treatment.
Why is it performed?
Thanks to this radiotherapeutic procedure, a better therapeutic approach and a reduction in the number of treatment sessions is achieved, which translates into a better quality of life for patients. Furthermore, thanks to hypofractionation, toxic side effects on healthy organs at risk close to the lesion are minimized.
The indications for this form of hypofractionated radiotherapy were for palliative treatment at low doses; however, its application is now widespread as a treatment for numerous tumors, especially breast and prostate tumors. Likewise, the indications are being extended to the lung, rectum, oligometastasis, pancreas and bladder, although more studies are pending to prove the positivity of this form of irradiation for this type of tumors.
What does it consist of?
Hypofractionation consists of administering, with maximum precision and protecting the surrounding organs, daily doses of radiotherapy to the tumor in fewer treatment sessions than usual. This “faster” treatment modality has, among other benefits, reduced patient travel to the treatment units and a greater tumor effect.
In recent decades, advances have been made that are allowing more precise radiotherapy to be applied through advanced technology such as ‘CyberKnife’ or tomotherapy. The advantages it offers, such as precision, reliability and shorter treatment times, have made hypofractionation a therapeutic alternative for certain types of tumors, such as breast and prostate tumors.
Preparation for hypofractionation
When evaluating a patient with prostate pathology for the first time, the best option should always be considered. If external radiation therapy is indicated, hypofractionated intensity modulated external radiation therapy will be suggested. This is the most effective alternative for low-risk or intermediate and high-risk patients. In other words, all of them could be included in the moderate hypofractionation scheme.
Post-procedure care
This new application preserves optimal results, good tolerance and low risk of complications after treatment.