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In recent years, hypofractionated radiotherapy has gained importance and currently represents the recommended standard in adjuvant breast cancer treatment for many patients. So far, the impact of hypofractionation on the effect of incidental lymph node irradiation has not be addressed.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Biological effective dose (BED) and tumor control probability (TCP) were estimated for four different hypofractionated radiation schemes (42.50\u202fGy in 16\u00a0fractions [Fx]; 40.05\u202fGy in 15\u00a0Fx; 27\u202fGy in 5\u00a0Fx; and 26\u00a0in 5\u00a0Fx) and compared to conventional fractionation (50\u202fGy in 25\u00a0Fx). For calculation of BED and TCP, a\u00a0previously published radiobiological model with an \u03b1\/\u03b2 ratio of 4\u202fGy was used. The theoretical BED and TCP for incidental irradiation between 0\u00a0and 100% of the prescribed dose were evaluated. Subsequently, we assessed BED and TCP in 431 axillary lymph node metastases.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The extent of incidental lymph node irradiation and the fractionation scheme have a\u00a0direct impact on BED and TCP. The estimated mean TCP in the axillary nodes ranged from 1.5\u202f\u00b1\u20096.4% to 57.5\u202f\u00b1\u200922.9%, depending on the patient\u2019s anatomy and the fractionation scheme. Hypofractionation led to a\u00a0significant reduction of mean TCP of lymph node metastases for all schedules.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our data indicate that hypofractionation might affect the effectiveness of incidental radiotherapy in the axilla. This is particularly relevant for patients with positive sentinel lymph nodes who receive SLNB only.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00066-020-01636-6","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T08:04:32Z","timestamp":1591085072000},"page":"771-778","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of hypofractionation on the incidental axilla dose during tangential field radiotherapy in breast cancer"],"prefix":"10.1007","volume":"196","author":[{"given":"Kai J.","family":"Borm","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Oechsner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"D\u00fcsberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Buschner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weber","family":"Wolfgang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie E.","family":"Combs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0205-4411","authenticated-orcid":false,"given":"Marciana N.","family":"Duma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"issue":"3","key":"1636_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.prro.2018.01.012","volume":"8","author":"BD Smith","year":"2018","unstructured":"Smith\u00a0BD et al (2018) Radiation therapy for the whole breast: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline. 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S.E.\u00a0Combs: advisory boards\/advisor: BMS, Astra Zeneca, Roche, Novocure, Daiichi Sankyo, Icotec; speaker honoraria: BMS, Astra Zeneca, Roche, Novocure, Daiichi Sankyo, Icotec, Brainlab, varian, Accuray, Zeiss Meditec, Dr. Sennewald, Elekta, Merck Darmstadt, Medac.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}