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“Background Breast radiation therapy after conservative surgery is now widely accepted as a standard of care for patients with early GSK872 breast cancer. Moreover breast conserving therapy has become an accepted treatment option over radical mastectomy for stage I – II breast tumour [1–3]. The conventional radiation course consists of 50 Gy in 25 daily fractions of 2 Gy on the whole breast usually followed by the addition of a boost dose to the tumour bed of 10 to 16 Gy in 5 – 8 daily fractions resulting in overall 6 – 7 week treatment. However, in certain patient populations like the elderly and those living far from radiation facilities, adjuvant

breast radiotherapy appears to be underutilized because of the substantial length of treatment. Delivering postoperative radiotherapy in a shorter period of time could effectively be much more convenient for these patients.

That is, a shorter schedule of radiotherapy, as an accelerated GSK126 purchase hypofractionated regimen, could indeed improve the use of breast conserving therapy helping to knock down selleck chemical the “”logistical barriers”"(in terms of age, aged-related morbidity, time, travel difficulties, absence from family and job, cost etc) and consequently providing more women with this option. This accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule. The relationship between total dose, fraction size and tissue response is described by the α/β value (expressed in Gy) in Linear Quadratic (LQ) model [4]. Increasing evidence from randomized trials comparing conventional radiotherapy schedules

Tolmetin to different hypofractionated ones in whole breast irradiation after conserving surgery show that breast adenocarcinoma may be associated with lower α/β value than previously thought and closer to those of late-reacting healthy tissues [5–9]. The LQ model suggests that, when the α/β ratio for the tumour is similar to that of the surrounding late-responding normal tissue, the hypofractionated regimen may be equally or potentially more effective than the conventional one [10]. On this basis patients at our Institute who refused to spend 6 to 7 weeks in radiotherapy after breast conserving surgery were offered an accelerated hypofractionated radiation therapy schedule consisting of 10 daily fractions of 3.4 Gy to whole breast plus a boost dose of 8 Gy in a single fraction to the tumour bed. The paper aims to report a preliminary analysis focusing on the early and late skin and lung toxicity after this accelerated hypofractionated regimen. Lung toxicity was investigated in terms of CT density evaluation, pulmonary functional tests, and clinical and radiological scoring.