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FAST-Forward cut breast radiotherapy to five treatments in a single week and showed the same low relapse rate as the three-week standard, with similar late effects at five years.
FAST-Forward randomised 4,096 women with early breast cancer to 40 Gy in 15 fractions, 27 Gy in five or 26 Gy in five fractions over one week. Five-year ipsilateral breast tumour relapse was 2.1 percent after 40 Gy and 1.4 percent after 26 Gy, meeting the non-inferiority margin; late normal-tissue effects after 26 Gy were similar to the standard arm while 27 Gy gave more (Murray Brunt and colleagues, Lancet 2020). One-week radiotherapy became standard in the UK and, accelerated by the pandemic, widely elsewhere.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
4,096 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Ipsilateral breast tumour relapse at 5 yearsprimary | 26 Gy in 5 fractions | 1,368 | 1.4% | - | - | - |
| 40 Gy in 15 fractions | 1,361 | 2.1% |
Shares FAST (5-fraction whole-breast radiotherapy), START-A (UK Standardisation of Breast Radiotherapy, trial A), Partial-breast irradiation, Hypofractionation (fewer, larger radiotherapy doses) and the tag radiation-wave2.
Shares Partial-breast irradiation, Hypofractionated radiotherapy, HER2-positive breast cancer, Breast cancer (all types) and the tag radiation-wave2.
Shares Partial-breast irradiation, HER2-positive breast cancer, Breast cancer (all types), IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares Non-inferiority margin and equivalence trials, Non-inferiority trial, Hypofractionated radiotherapy and the tag radiation-wave2.
Shares Hypofractionation (fewer, larger radiotherapy doses), Hypofractionated radiotherapy, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares Breast cancer (all types), IMRT / IGRT (modern external beam), HR-positive / HER2-negative breast cancer and the tag radiation-wave2.
Shares Breast cancer (all types), IMRT / IGRT (modern external beam), HR-positive / HER2-negative breast cancer and the tag radiation-wave2.
Shares Breast cancer (all types), HR-positive / HER2-negative breast cancer and the tag radiation-wave2.