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One week of breast radiotherapy in five doses works as well as three weeks in fifteen, but clinics paid per dose lose money by switching; paying one price per course removes the penalty.
FAST-Forward (Lancet 2020) showed 26 Gy in five fractions over one week was non-inferior to 40 Gy in fifteen fractions for local recurrence after breast surgery. Prostate, rectal, lung and palliative bone regimens have similar evidence. Fee-for-fraction payment makes the shorter course a revenue loss for the centre. Medicare's Radiation Oncology Model proposed episode payments; a simpler per-course rate for the common sites would align the incentive with the evidence.
Shares Four weeks or five treatments, not seven and a half weeks, for prostate radiotherapy, One week of breast radiotherapy in five treatments as the default after surgery, Knowledge reaches practice too slowly, Surgery and radiotherapy cure most, get least.
Shares Incentives reward me-too drugs and marginal gains, Surgery and radiotherapy cure most, get least, SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam).
Shares Four weeks or five treatments, not seven and a half weeks, for prostate radiotherapy, SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam), Prostate cancer.
Shares Four weeks or five treatments, not seven and a half weeks, for prostate radiotherapy, One week of breast radiotherapy in five treatments as the default after surgery, Surgery and radiotherapy cure most, get least, IMRT / IGRT (modern external beam).
Shares Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial, One week of breast radiotherapy in five treatments as the default after surgery, IMRT / IGRT (modern external beam), HR-positive / HER2-negative breast cancer.
Shares American Society for Radiation Oncology, SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam).
Shares American Society for Radiation Oncology, SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam).
Shares American Society for Radiation Oncology, IMRT / IGRT (modern external beam), Prostate cancer.
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