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Is your decision to hypofractionate or boost altered by surgeon's plans for DIEP reconstruction after radiotherapy?

Would you ever offer pre-operative radiotherapy in carefully selected patients before primary oncologic surgery off-trial, based on this Lancet Oncology paper? https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22)00145-0/fulltext#
1 Answer
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Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on

I would not offer pre-operative RT off trial at this time.

If planning for lumpectomy, I would use my standard consideration (moderate hypofractionation standard, can consider 5 fx WBI for appropriately selected) and boost factors (age < 50, ER-, margins). It's unclear the rationale for a DIEP post ...

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