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Giving radiotherapy in fewer, bigger daily doses (fractions) so a course takes one to three weeks instead of five to seven. Randomised trials showed equal control and side effects in breast (START, FAST-Forward) and prostate (CHHiP, PACE-B) cancer, and a single dose suffices for bone pain; adoption lags where health systems are paid per fraction.
Normal tissue tolerates radiation better when it is split into daily fractions, historically 1.8-2 Gy over 5-7 weeks. Randomised trials showed moderate hypofractionation (2.7-3 Gy, 15-20 fractions) is equivalent in breast (START, whole-breast 40 Gy/15) and prostate (CHHiP, PROFIT), and ultra-hypofractionation (5 fractions: FAST-Forward for breast 26 Gy/5, PACE-B for prostate) also holds up. Single 8 Gy fractions suffice for bone pain. SBRT takes the principle to its extreme. Short-course (5 × 5 Gy) rectal radiotherapy is part of total neoadjuvant therapy. Adoption lags in some health systems that are paid per fraction.
Shares FAST (5-fraction whole-breast radiotherapy), START-A (UK Standardisation of Breast Radiotherapy, trial A), START-B (UK Standardisation of Breast Radiotherapy), The linear-quadratic model and fractionation.
Shares PROFIT (Prostate Fractionated Irradiation Trial), RTOG 0415, How many radiotherapy visits: the prostate fractionation trials, CHHiP.
Shares RTOG 0415, How many radiotherapy visits: the prostate fractionation trials, CHHiP, Non-inferiority margin and equivalence trials.
Shares Tumour bed boost, RAPID (accelerated partial-breast irradiation), Partial-breast irradiation, Hypofractionated radiotherapy.
Shares RAPID (accelerated partial-breast irradiation), Partial-breast irradiation, Lumpectomy (breast-conserving surgery), Breast cancer (all types).
Shares Tumour bed boost, Lumpectomy (breast-conserving surgery), Hypofractionated radiotherapy, Breast cancer (all types).
Shares Gray unit (Gy), Brachytherapy (internal radiotherapy), Stereotactic body radiotherapy (SBRT / SABR), Colorectal cancer.
Shares RAPID (accelerated partial-breast irradiation), Partial-breast irradiation, Breast cancer (all types), HR-positive / HER2-negative breast cancer.