NEW research presented at ESMO Breast 2025 suggests that hypofractionated radiotherapy (HFRT) is as effective as conventional fractionated radiotherapy (CFRT) in breast cancer patients who require regional nodal irradiation (RNI) after surgery.
Using data from the Baden-Württemberg Cancer Registry (BWCR), researchers examined outcomes in 4,119 women diagnosed with early-stage breast cancer between 2009 and 2021. All patients had undergone upfront surgery and were indicated for RNI under German clinical guidelines. Of the total cohort, 15.9% received HFRT, delivered over fewer sessions with a higher dose per fraction, while 84.1% were treated with standard, longer-course CFRT.
The analysis found that patients receiving HFRT were, on average, older (59.9 vs. 56.6 years) and more likely to have favourable tumour features. Even so, after adjusting for key variables such as tumour stage, nodal involvement, age, tumour subtype, chemotherapy use, and surgery type, there was no significant difference in long-term outcomes. Multivariate analysis showed no impact of radiotherapy type on overall survival (hazard ratio [HR] 0.82, 95% CI 0.60-1.10) or breast cancer-specific survival (HR 0.76, 95% CI 0.54-1.07).
These real-world findings align with results from recent clinical trials and suggest that HFRT is a viable alternative to CFRT for patients requiring nodal irradiation, offering comparable effectiveness with potentially greater convenience and reduced treatment burden.
Reference
Pfob A et al. Oncologic outcomes of hypofractionated vs conventionally fractionated radiotherapy in breast cancer patients with an indication for regional nodal irradiation: A cancer registry study. Abstract 161P. ESMO Breast; 14-17 May 2025.
