ObjectiveTo systematically evaluate the efficacy, cosmetic outcome and adverse reaction of hypofractionation radiotherapy (HRT) versus conventional radiotherapy (CRT) for early stage breast cancer after breast conserving surgery. MethodsThe databases including CNKI, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 1, 2015) were searched from the inception to May 2015 to collect the randomized controlled trials (RCTs) related to HRT versus CRT for early stage breast cancer after breast conserving surgery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsSix RCTs involving 8 240 patients were included. Meta-analyses results showed, there were no statistical differences between the HRT group and the CRT group in local-regional recurrence rate (5 year: RR=1.01, 95%CI 0.73 to 1.40, P=0.94; 10 year: RR=1.04, 95%CI 0.86 to 1.26, P=0.67), mortality (5 year: RR=0.95, 95%CI 0.85 to 1.08, P=0.45; 10 year: RR=0.97, 95%CI 0.86 o 1.09, P=0.61), photographic breast appearance (RR=0.98, 95%CI 0.91 to 1.05, P=0.56), the incidence of lung fibrosis (5 year: RR=1.07, 95%CI 0.66 to 1.72, P=0.78; 10 year: RR=1.05, 95%CI 0.62 to 1.77, P=0.86), the incidence of rib fracture (5 year: RR=1.00, 95%CI 0.60 to 1.68, P=0.99; 10 year: RR=1.19, 95%CI 0.70 to 2.00, P=0.52), and the incidence of ischemic of heart (5 year: RR=0.88, 95%CI 0.54 to 1.45, P=0.62; 10 year: RR=0.86, 95%CI 0.54 to 1.37, P=0.53). ConclusionHRT could provide similar tumor control as CRT without serious toxicity. Meanwhile HRT is superior to CRT in terms of patient convenience and costs, it should be promoted as adjuvant treatment for early stage breast cancer after breast conserving surgery.