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This narrative review synthesizes evidence across multiple malignancies, including established moderate HFRT standards for breast cancer after breast-conserving surgery, comparable biochemical control in localized prostate cancer, and effective early-stage glottic tumor control with acceptable toxicity.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/hypofractionated-radiotherapy-across-cancer-sites-a-narrative-review-of-evidence-and-implementation/357001/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/hypofractionated-radiotherapy-across-cancer-sites-a-narrative-review-of-evidence-and-implementation/357001.png","ImageObject",300,407,{"name":42,"@type":43},"Dipper","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-25","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is hypofractionated radiotherapy (HFRT) and how does it act as de-escalation?","Question",{"text":62,"@type":63},"HFRT gives a higher dose per fraction over fewer treatment sessions. It reduces overall treatment burden while aiming to preserve tumor control, functioning as a de-escalation approach in radiation oncology.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What outcomes has HFRT shown in breast cancer and prostate cancer?",{"text":67,"@type":63},"For breast cancer after breast-conserving surgery, randomized trials support moderate HFRT as standard care. For localized prostate cancer, trials report equivalent biochemical control compared with conventional fractionation.",{"name":69,"@type":60,"acceptedAnswer":70},"How is HFRT used in palliative settings and what barriers affect adoption?",{"text":71,"@type":63},"In palliation, single-fraction radiotherapy is established for painful bone metastases, and split-course regimens such as QUAD shot can provide effective symptom relief for bulky tumors. Adoption varies across regions due to barriers like reimbursement structures and institutional capacity.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},357001,1790318475,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":26,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Japanese Journal of Clinical Oncology, 2026, 56(6), 669–679 [https://doi.org/10.1093/jjco/hyag054](https://doi.org/10.1093/jjco/hyag054)  \n[Published: 14 April 2026](Published: 14 April 2026)  \nReview Article  \n| Hypofractionated radiotherapy across cancer sites: a narrative review of evidence and implementation\u003Cbr>Masahiro Inada, Takuya Uehara , Yukinori Matsuo*  |  |\n| --- | --- |\n| Department of Radiation Oncology, Kindai University Faculty of Medicine, 1-14-1 Mihara-dai, Minami-ward, Sakai, Osaka, 590-0197, Japan\u003Cbr>*Corresponding author. Department of Radiation Oncology, Kindai University Faculty of Medicine, 1-14-1 Mihara-dai, Minami-ward, Sakai, Osaka, 590-0197, [Japan. E-mail: ymatsuo@med.kindai.ac.jp](Japan. E-mail: ymatsuo@med.kindai.ac.jp)\u003Cbr>Abstract\u003Cbr>Hypofractionated radiotherapy (HFRT), which delivers higher doses per fraction in fewer treatment sessions, represents a practical form of de-escalation in radiation by shortening overall treatment time and reducing patient burden. This narrative review summarizes the current evidence for HFRT across various malignancies. For breast cancer, randomized trials includingthe START trials and JCOG 0906 have established moderate HFRT (40–42.56 Gy in 15–16 fractions) as standard care after breast-conserving surgery. In localized prostate cancer, multiple trials have demonstrated equivalent biochemical control with moderate HFRT compared to conventional fractionation. For early-stage glottic cancer, HFRT achieves comparable or superior local control with acceptable toxicity. In elderly glioblastoma patients, HFRT with concurrent temozolomide has become a standard treatment option. For vulnerable patients unable to tolerate standard chemoradiotherapy, HFRT provides a valuable alternative, although caution is required when combining with chemotherapy. In palliative settings, single-fraction radiotherapy is established for painful bone metastases, while split-course regimens such as QUAD shot offer effective palliation for bulky tumors. Despite robust evidence, HFRT adoption varies across regions, with barriers including reimbursement structures and institutional capacity. HFRT reduces healthcare costs while maintaining outcomes, making it an attractive option in resource-limited settings. Continued efforts are needed to promote evidence-based HFRT implementation worldwide.\u003Cbr>Keywords hypofractionated radiotherapy, de-escalation, breast cancer, prostate cancer, palliative radiotherapy |  |\n| Introduction\u003Cbr>Treatment de-escalation has been actively discussed in the field of oncology. In clinical practice, de-escalation has been applied in various forms: shortening treatment duration and reducing drug dosages in medical oncology, and reducing the extent of surgical resection in surgical oncology. Ferrero et al. outlined the primary objectives of de-escalation as follows: improving patients’quality of life by reducing treatment-related toxicity, minimizing inherent toxicities and long-term sequelae associated with anticancer therapies, and reducing the significant costs linked to often-expensive cancer treatments [1] .\u003Cbr>In the field of radiation oncology, de-escalation strategies such as reducing prescription doses or decreasing irradiation volumes have been explored, particularly in head and neck cancers [2] . However, the evidence supporting de-escalation of treatment intensity remains insufficient. In contrast, hypofractionated radiotherapy (HFRT), which uses a higher dose per fraction with fewer fractions, has been investigated for many years, and accumulating evidence has established its efficacy and safety | in specific malignancies. In this context, hypofractionation can be regarded as a form of de-escalation in radiotherapy when it preserves tumor control while reducing overall treatment burden and improving patient convenience.\u003Cbr>Coutard and colleagues refined and systematized the principle of fractionated irradiation [3], and thereafter curative radiotherapy for ma","cbCaihYZ5YJOiuou","https://ap.wps.com/l/cbCaihYZ5YJOiuou","pdf",875757,11,"English","# Abstract\n# Introduction","[{\"question\":\"What is hypofractionated radiotherapy (HFRT) and how does it act as de-escalation?\",\"answer\":\"HFRT gives a higher dose per fraction over fewer treatment sessions. It reduces overall treatment burden while aiming to preserve tumor control, functioning as a de-escalation approach in radiation oncology.\"},{\"question\":\"What outcomes has HFRT shown in breast cancer and prostate cancer?\",\"answer\":\"For breast cancer after breast-conserving surgery, randomized trials support moderate HFRT as standard care. For localized prostate cancer, trials report equivalent biochemical control compared with conventional fractionation.\"},{\"question\":\"How is HFRT used in palliative settings and what barriers affect adoption?\",\"answer\":\"In palliation, single-fraction radiotherapy is established for painful bone metastases, and split-course regimens such as QUAD shot can provide effective symptom relief for bulky tumors. Adoption varies across regions due to barriers like reimbursement structures and institutional capacity.\"}]","Hypofractionated radiotherapy across cancer sites - A narrative review of evidence and implementation | PDF",1790128573,28]