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.