Systematic Review and Meta-Analysis of Hypofractionated and Conventional Fractionated Radiotherapy on Survival in Breast Cancer Patients Publisher



Haghiri A ; Zebardast J ; Akbari A ; Kalantari Khandani M ; Shakiba M ; Shahrabi Farahani N ; Akbari M E ; Eslami M
Source: Immunopathologia Persa Published:2026

Abstract

Introduction: Breast cancer is the most common malignancy among women around the world, and considering the low α/β ratio, it appears that the efficiency of hypofractionated radiotherapy (HFRT) is equal to conventional fractionated radiotherapy (CFRT). Accordingly, the goal of this meta-analysis was to estimate the survival rate of patients with breast cancer after hypofractionated radiotherapy and CFRT treatments. Materials and Methods: Databases Web of Science, Cochrane, Scopus, PubMed, Embase, and Google Scholar search engine were used for articles published until August 20, 2025. Data was analyzed using STATA 14. Tests with P values<0.05 were considered statistically significant. Results: The overall survival rate of breast cancer patients after CFRT and their disease-free survival (DFS) rate were 89% and 86%, respectively. The overall survival rate of breast cancer patients after hypofractionated radiotherapy and ultra - hypofractionated radiotherapy was 83% and 85%, respectively. Furthermore, the overall survival rate of breast cancer patients after hypofractionated radiotherapy in Asia was 79%, Europe 83%, America 86%, Africa 90%, in follow-ups under 5 years was 89%, in follow-ups equal to 5 years or longer was 81%, in women aged 40 to 49 was 82%, women aged 50 to 59 was 85%, women aged 60 to 69 was 86%, women aged 70 to 79 was 82%, and women aged 80 to 89 was 59%. The DFS rate of breast cancer patients after hypofractionated radiotherapy and U- hypofractionated radiotherapy was 87% and 95%, respectively. Additionally, the DFS rate of breast cancer patients after hypofractionated radiotherapy in women aged 40 to 49 was 82%, women aged 50 to 59 was 86%, women aged 60 to 69 was 97%, women aged 70 to 79 was 88%, in Asia 77%, Europe 95%, America 93%, Africa 95%, in follow-ups under five years was 94%, and in follow-ups equal to or longer than five years was 84%. Conclusion: There was a slight difference in overall survival between the two methods of hypofractionated radiotherapy and CFRT, whereas their DFS rate after hypofractionated radiotherapy and U- hypofractionated radiotherapy was higher than that of CFRT. Furthermore, the overall survival rate following hypofractionated radiotherapy in Africa and follow-ups under five years was equal to or higher than that of CFRT treatment. Considering the reduced number of treatment sessions and costs in the hypofractionated radiotherapy method and the minor difference in the overall survival rates of hypofractionated radiotherapy and CFRT methods, it appears that hypofractionated radiotherapy is a more effective treatment method. © 2026, Nickan Research Institute. All rights reserved.Copyright © 2026 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.