{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:04:57Z","timestamp":1779789897873,"version":"3.53.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer is one of the most frequent cancers globally, and radiotherapy plays an important key role in reducing the chance of recurrence following breast-conserving surgery. As an alternative to traditional fractionated radiotherapy (CFRT), hypofractionated whole-breast irradiation (HFRT) has gained popularity since it provides similar oncological results over shorter treatment periods. Nevertheless, the comparative effectiveness and safety profile of hypofractionated versus conventional fractionation schedules remains an area of ongoing evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of HFRT versus CFRT in patients with breast cancer, with particular emphasis on disease-free survival and treatment-related toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of PubMed, Cochrane Library, Scopus, Web of Science, and Embase was conducted through December 2024. Randomized controlled trials (RCTs) and comparative studies evaluating HFRT versus CFRT in early-stage breast cancer. Key outcomes assessed included disease-free survival (DFS) and treatment-related toxicities, particularly lymphedema and acute radiation dermatitis. The Mantel\u2013Haenszel method to calculate risk ratios (RRs) with 95% confidence intervals (CI) was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies comprising 5,495 breast cancer patients were identified. The meta-analysis demonstrated no significant differences in disease-free survival (DFS) in 5 years (\n                      <jats:italic>RR = 1.01, 95% CI 0.96\u20131.06; P\u00a0=\u00a00.83<\/jats:italic>\n                      ). Similarly, no significant difference was observed in the incidence of lymphedema between HFRT and CFRT (RR\u00a0=\u00a01.19, 95% CI 0.94\u20131.51; P\u00a0=\u00a00.15). Regarding acute radiation dermatitis, a statistically significant difference favoring HFRT was observed under the fixed-effects model (RR\u00a0=\u00a01.62, 95% CI 1.20\u20132.18; P\u00a0=\u00a00.002). However, due to substantial heterogeneity across studies (I\u00b2 = 90%), a random-effects model was applied, which demonstrated no statistically significant difference between treatment groups (RR\u00a0=\u00a01.43, 95% CI 0.51\u20134.01; P\u00a0=\u00a00.50). These results should be interpreted with caution given the high between-study variability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HFRT demonstrated comparable oncological outcomes to CFRT, with a trend toward reduced acute skin toxicity, indicating that it could be a promising therapy option for early-stage breast cancer. Standardizing radiation treatments and evaluating long-term toxicity and patient-reported results should be the goals of future research. Also, the observed variability across studies warrants cautious interpretation of the pooled estimates, particularly for outcomes demonstrating substantial heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD42025631012.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1779983","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:49:04Z","timestamp":1778647744000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of hypofractionated versus conventional radiotherapy in breast cancer: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Malek","family":"Talal","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Minia University","place":["Minia, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marafi Jammaa","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Bahri","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad M.","family":"Elsharkawy","sequence":"additional","affiliation":[{"name":"Alexandria Faculty of Medicine","place":["Alexandria, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa R.","family":"AL-Ihribat","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, Palestine Polytechnic University","place":["Hebron, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed F.","family":"Srour","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Menoufia University","place":["Shebin El Kom, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef Z.","family":"Farhat","sequence":"additional","affiliation":[{"name":"Misr University for Science and Technology","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Youssef","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tanta University","place":["Tanta, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabeia Babiker","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nile Valley University","place":["Atbara, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Wafa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Mansoura University","place":["Mansoura, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Werdany","family":"Hassan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Minia University","place":["Minia, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Ahmed Shimal","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Baghdad","place":["Baghdad, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omran","family":"Shrebaty","sequence":"additional","affiliation":[{"name":"College of Medicine, Sulaiman Al Rajhi University","place":["Al Bukayriyah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Moqbel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21863","article-title":"Breast cancer statistics 2024","volume":"74","author":"Giaquinto","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61629-2","article-title":"Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10\u2013801 women in 17 randomised trials","volume":"378","author":"Darby","year":"2011","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70077-9","article-title":"The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial","volume":"9","author":"Bentzen","year":"2008","journal-title":"Lancet Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(13)70386-3","article-title":"The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial","volume":"371","author":"Bentzen","year":"2008","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0906260","article-title":"Long-term results of hypofractionated radiation therapy for breast cancer","volume":"362","author":"Whelan","year":"2010","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.53841\/bpsicpr.2020.15.2.123","article-title":"Cochrane Handbook for systematic reviews of interventions","volume":"15","author":"Higgins","year":""},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.31222\/osf.io\/v7gm2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"","journal-title":"BMJ"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.13370","article-title":"Whole-breast radiotherapy with boost for node-negative breast cancer: conventional vs. hypo-fractionation","volume":"37","author":"Rades","year":"2023","journal-title":"In Vivo"},{"key":"B12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.breast.2020.11.020","article-title":"Hypofractionated versus conventional fractionated radiotherapy for breast cancer in patients with reconstructed breast: toxicity analysis","volume":"55","author":"Kim","year":"2021","journal-title":"Breast"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(18)30813-1","article-title":"Hypofractionated versus conventional fractionated postmastectomy radiotherapy for patients with high-risk breast cancer: a randomised, non-inferiority, open-label, phase 3 trial","volume":"20","author":"Wang","year":"2019","journal-title":"Lancet Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-12-495","article-title":"Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy","volume":"12","author":"Versmessen","year":"","journal-title":"BMC Cancer"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/jco.20.01363","article-title":"Hypofractionated versus standard fractionated radiotherapy in patients with early breast cancer or ductal carcinoma In Situ in a randomized phase III trial: the DBCG HYPO trial","volume":"38","author":"Offersen","year":"2020","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.2652","article-title":"Hypofractionated vs conventionally fractionated postmastectomy radiation after implant-based reconstruction: a randomized clinical trial","volume":"10","author":"Wong","year":"2024","journal-title":"JAMA Oncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"46","DOI":"10.21608\/resoncol.2019.12516.1078","article-title":"Randomized prospective study comparing conventional versus hypofractionated adjuvant radiotherapy in node-positive breast cancer","volume":"15","author":"Atef","year":"2019","journal-title":"Res Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1378-x","article-title":"Conventional versus hypofractionated postmastectomy radiotherapy: a report on long-term outcomes and late toxicity","volume":"14","author":"Chitapanarux","year":"","journal-title":"Radiat Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.25881","article-title":"Analysis of breast cancer mortality in the US-1975 to 2019","volume":"331","author":"Caswell-Jin","year":"2024","journal-title":"JAMA"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.738851","article-title":"Risk factors related to acute radiation dermatitis in breast cancer patients after radiotherapy: a systematic review and meta-analysis","volume":"11","author":"Xie","year":"","journal-title":"Front Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.19202","article-title":"Predictive factors associated with acute radiation dermatitis in patients with breast cancer: a retrospective cohort study","volume":"13","author":"Nanthong","year":"","journal-title":"PeerJ"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10402-z","article-title":"Acute skin toxicity of conventional fractionated versus hypofractionated radiotherapy in breast cancer patients receiving regional node irradiation: the real-life prospective multicenter HYPOBREAST cohort","volume":"22","author":"Bruand","year":"","journal-title":"BMC Cancer"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1779983\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:35:42Z","timestamp":1779788142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1779983\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":22,"alternative-id":["10.3389\/fonc.2026.1779983"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1779983","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"1779983"}}