4-Week (Hypofractionated) vs. 6-Week Radiation

inccmd · July 2017

Been going through different threads and reading. In the US, age seems to be a big consideration along with diagnosis.

I'm considering hypofractionated radiation therapy (leaning towards it based on all of your comments). Have to decide by early next week. My MO recommended it if my RO agreed I met the criteria. I just met with my local RO who doesn't like to offer in general and not to those under 50. She prefers those 55 and older. I'm 48. She wants more data for longer period of time. Most of my care has been at a more progressive hospital that has really good breast specialists where the MO and surgeon are. I got the RO to agree to give me the option, but I am thinking I should have kept the longer drive where the ROs are more likely to embrace it. Done plenty of research and still leaning towards hypofractionated. Except for age, I meet all the other American criteria (criteria is different in Canada and England) : small tumor (1.1 cm), lumpectomy, no lymph node involvement, no chemo, right side.

Thoughts? Experience? Age?

sfar · July 2017

I did have hypofractionated radiation treatment. I am 60 and did receive chemo as well. The only side effect I suffered was some fatigue (but I was anemic & had just finished chemo). I turned a little pink and used the Eucerin Cream they gave me before bed and never peeled etc.

inccmd · July 2017

I start on August 1, so I'm a bit nervous. Thank you for commenting!

BrooksideVT · July 2017

Here's an article addressing recommendations for updating of ASTRO (American Society of Radiation Oncologists) guidelines. Use of the hypofractionated protocol in selected groups under age 50 is considered "cautionary."

http://www.practicalradonc.org/article/S1879-8500(16)30184-9/pdf

I've read only the summary, and strongly suggest familiarizing yourself with this article, and others, and discussing this with both the RO at your nearby hospital and the RO at the second hospital you mention., and maybe your MO as well.

For me, the word, "cautionary" indicates, well, caution.

BrooksideVT · July 2017

Actually, I just tried that link and it did not work. I found it by clicking, "Breast Cancer" on the site that I hope will show up if you click the address below. Again, ASTRO is the American Society of Radiation Oncologists.

https://www.astro.org/Clinical-Practice-Statements...

inccmd · July 2017

Thank you for the article. It actually follows a study that is different than what I am choosing. It's talking about accelerated partial breast versus whole breast. I am having whole breast, but over 4 weeks instead of 6. It was interesting to go through, although it covers ductal and I have lobular. I am certainly happy that I'm having whole breast based on what I read.

I've read many articles, but I think this shorter one summarizes pretty well: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629948/

Again this covers mostly ductal, but it shows that the two treatments (4 & 6) are statistically insignificant in terms in of survival. I not not going to have the 16 doses and mentioned in the article - I'll have 20 doses, so a bit lower daily radiation dose than in the studes they summarize. Somewhere else I read where the sides effects and quality of life is better with the shorter course.

ShockedAt48 · July 2017

I just had my consultation with my oncologist radiology doctor this morning. Didn't really care for him but oh well. I am going to receive 3 weeks @ 15 treatments which is the accelerated whole breast program. I asked about the boost and he said it was not necessary since my margins were clear. I thought the boost to the tumor bed was standard treatment? Is anyone having their treatments in a prone position vs. supine?

inccmd · July 2017

I've heard that some had boosts while others have not. The part about margins makes sense. My treatment will be supine because of the equipment, but they are moving to prone which I think is better because less of the radiation hits the rest of the body - less likely to have issues with heart, lung, ribs.

RedMoon · October 2017

What is hypofractionated radiation? Is one better than the other? My RO is recommending 16 sessions, she didn't say which kind. Does it work better to have more rather than less? I read somewhere that they give older women less treatment (hopefully not because we are going to die sooner anyway)

Kaso · October 2017

I am 64 years young. My IDC was 1.5 with 5 clear sentinel nodes and clear margins. My oncotype was 11. My RO recommended 19 sessions with the last 5 being boosts to the tumor site. Each dose was about 267 beams for a total just over 5,000 beams that would stay working for a couple of weeks after treatment. I need to put my trust in my RO & did.

ShockedAt48 · October 2017

Redmoon: Here's an article about the difference:

http://www.breastcancer.org/research-news/benefits...

I had 15 days spread out over three weeks and I've heard that the side effects for skin damage and fatigue are much better for the shorter duration. You end up getting higher dosages of radiation for a shorter time that ends up being slightly less radiation than the longer treatment.

tlfrank · November 2017

Does anyone know if there is an anatomical reason to do one method over the other? I seem to remember my RO saying that she wouldn't know if we can do the shorter term on my case until the "mapping" study is done? I'm not sure if I'm remembering her words correctly....

I appreciate all of you ladies so much!

4-Week (Hypofractionated) vs. 6-Week Radiation

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