SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
Research–Evidence Gap Analysis of Hypofractionated Radiotherapy for Breast Cancer: A Bibliometric Knowledge Graph Study
Provisionally accepted
- 1Shandong Second Medical University, Weifang, China
- 2Shandong Second Medical University - Yuhe Campus, Weifang, China
- 3Shandong First Medical University Cancer Hospital, Jinan, China
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Abstract Background: Hypofractionated radiotherapy (HFRT) has become a standard option for early-stage breast cancer, supported by multiple randomized controlled trials and endorsed by major guidelines. However, whether research production, high-level evidence, and clinical guideline adoption are fully aligned remains unclear. Methods: Publications on HFRT for breast cancer (2014–2024) were retrieved from the Web of Science Core Collection. Bibliometric analyses were performed using CiteSpace (6.4.R1) and VOSviewer (1.6.20) to assess publication trends, collaboration networks, keyword clustering, and highly cited references. In parallel, clinical trials from PubMed were reviewed to evaluate the evolution of clinical evidence. A knowledge-mapping framework was applied to identify research evidence gaps. Results: A three-phase developmental pattern was identified: slow growth (2014–2019), rapid expansion (2019–2021), and stabilization (2021– 2024). Italy, the United States, and China accounted for more than 60% of global publications. Research hotspots shifted from efficacy validation to toxicity, dose optimization, and patient-centered outcomes. Although efficacy evidence is well established, significant gaps persist, including (i) limited long-term cardiac and pulmonary toxicity data, (ii) inconsistent cosmetic and quality-of-life reporting—especially among younger patients, and (iii) insufficient evidence for locally advanced disease or post-reconstruction irradiation.
Keywords: Bibliometrics, breast cancer, Evidence gap, Hypofractionated radiotherapy (HFRT), knowledge graph
Received: 15 Nov 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Liu, Wang, Xu, Liu, Xing, Wang, Zhao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shuai Wang
Xiaohua Zhao
Longgang Wang
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