Do you offer ultra-hypofractionated 5-fraction RT regimens for DCIS s/p lumpectomy?

The premise of this question attempts to "split" DCIS from early-stage invasive disease. When we live in an eternal present-tense, we naturally repeat the mistakes of the past. Again, as for modest hypofractionation, we are not going to see a "separate" clinical trial for pure DCIS in this space. In...

I would like to offer some of my thoughts regarding fractionation schemes for DCIS.

Short Answer:

Yes, DCIS patients can and should be offered ultra-hypofractionated whole breast radiation therapy. I would offer 2850 cGy in 5 fractions (once a week) according to the FAST protocol. My dose constraint...

I do routinely offer patients with DCIS, ultrashort courses of RT following lumpectomy. I have primarily used FAST approach (one fraction a week) but would also consider FAST-forward.

Our colleagues from Italy analyzed the long-term efficacy and safety of APBI in patients with low-risk DCIS enrolled in the APBI arm of the APBI-IMRT-Florence phase 3 trial (Tumori 2019). At a median f/u of 9.2 years, the 5- and 10-year local control was 100%. The 10-year overall survival rate was 9...