Is it time to re-evaluate the timing of radiation and chemotherapy with the adoption of hypofractionated courses of radiation for breast cancer?

Topics: Breast Cancer • Radiation Oncology

Historically, chemotherapy has been delivered prior to radiation for breast cancer patients requiring it.

With the acceptance of shorter courses of radiation treatment, is there a rationale for continuing this approach?

Answer from: Radiation Oncologist at Academic Institution

Clinicians began treating patients commonly with both RT and chemotherapy (CT) in the 1970s and 1980s. They tried many approaches, including giving RT first; giving all CT first; giving a "sandwich" of several cycles of CT, then RT, then completing CT; and giving concurrent RT and CT, with RT starte...

Comments

Radiation Oncologist at West Virginia University
Although I would agree that RT first clearly incre...

Radiation Oncologist at Beth Israel Deaconess Medical Center
Only 29% of patients in the WBI and APBI arms of t...

Answer from: Radiation Oncologist at Community Practice

I feel one situation where it needs to be addressed with discussion is for patients suitable for APBI as we use it for wider indications and need to be done before RT.

Answer from: Radiation Oncologist at Academic Institution

Yes, I believe hypofractionation has been introduced considering radiation prior to systemic therapy. Particularly when testing workups for systemic therapy can take some time. We are currently doing a trial where the boost of radiation is given preoperative and whole breast in just 11 fractions is ...

Comments

Radiation Oncologist at Cleveland Clinic
Agreed, for 5 fx (PBI or whole) ideal to deliver p...

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