{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:06:58Z","timestamp":1784714818392,"version":"3.55.0"},"reference-count":59,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: The safety of hypofractionated postmastectomy radiotherapy (HF-PMRT) in patients undergoing implant-based breast reconstruction remains uncertain because of concerns regarding radiation-related reconstructive complications. We conducted a systematic review and meta-analysis to compare reconstruction-related complications following HF-PMRT versus conventionally fractionated (CF) PMRT. Methods: PubMed, Cochrane Library, and EMBASE databases were searched through August 2025 following PRISMA guidelines. Studies comparing HF-PMRT with CF-PMRT in patients undergoing implant-based breast reconstruction were included. Outcomes were capsular contracture, implant or tissue expander removal, infection, and wound dehiscence. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using the Mantel\u2013Haenszel method. Subgroup analyses were performed by reconstruction stage (tissue expander vs. permanent implant). Results: Seven studies (n = 2200 patients; 1153 HF, 1047 CF) were analyzed, comprising two randomized controlled trials and five retrospective cohort studies. HF-PMRT was associated with a significantly lower risk of capsular contracture (OR 0.65, 95% CI 0.47\u20130.92) and wound dehiscence (OR 0.39, 95% CI 0.16\u20130.94) than CF-PMRT. Implant or tissue expander removal (OR 0.90, 95% CI 0.67\u20131.22) or infection (OR 0.98, 95% CI 0.67\u20131.44) did not differ. In subgroup analyses, reduction in capsular contracture was most evident when PMRT was delivered during the tissue expansion phase. Conclusions: These findings suggest that moderate hypofractionation is a reasonable fractionation option for implant-based breast reconstruction, with no evidence of increased reconstructive complications, although the certainty of evidence was limited, and prospective validation is warranted.<\/jats:p>","DOI":"10.3390\/jcm15145732","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:20:39Z","timestamp":1784712039000},"page":"5732","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypofractionated Versus Conventional Postmastectomy Radiotherapy in Implant-Based Breast Reconstruction: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9275-3197","authenticated-orcid":false,"given":"Ji Hyeon","family":"Joo","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0757-8211","authenticated-orcid":false,"given":"Yongkan","family":"Ki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-8556","authenticated-orcid":false,"given":"Youn-Joo","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Yul","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"},{"name":"Department of Surgery, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5072-4259","authenticated-orcid":false,"given":"Ki Seok","family":"Choo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5118-1903","authenticated-orcid":false,"given":"Kyung Jin","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Radiology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Bong","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"EBCTCG (Early Breast Cancer Trialists\u2019 Collaborative Group), McGale, P., Taylor, C., Correa, C., Cutter, D., Duane, F., Ewertz, M., Gray, R., Mannu, G., and Peto, R. 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