Unanswered questions

Important unanswered questions about the use of hypofractionated radiotherapy in early breast cancer are outlined below. Some of these questions may be addressed in ongoing trials:

  • Treatment outcomes for patients who received hypofractionated radiotherapy in relation to age and tumour size.
  • Optimal hypofractionated radiotherapy schedule.
  • Safety and efficacy of different tumour bed boost protocols administered after hypofractionated radiotherapy.
  • Safety and efficacy of hypofractionated regional nodal radiotherapy.
  • Hypofractionated radiotherapy for DCIS.
  • Potential interactions between adjuvant systemic therapies and hypofractionated radiotherapy.
  • Long-term effects of hypofractionated radiotherapy on cardiac toxicity.
  • Long-term effects of hypofractionated radiotherapy on rib morbidity.
  • Psychosocial outcomes for women receiving hypofractionated radiotherapy, including impact of hypofractionated radiotherapy on quality of life, such as side-effects and practical implications of a shorter treatment schedule.
  • Health economic considerations of hypofractionated radiotherapy.