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Trends and Patterns of Utilization of Hypofractionated Postmastectomy Radiotherapy: A National Cancer Database Analysis
| Content Provider | Scilit |
|---|---|
| Author | Venigalla, Sriram Guttmann, David M. Jain, Varsha Sharma, Sonam Freedman, Gary M. Shabason, Jacob E. |
| Copyright Year | 2018 |
| Description | Journal: Clinical breast cancer The acceptance of hypofractionated radiotherapy in treating breast cancer in the breast conservation therapy setting has stimulated interest in hypofractionated post-mastectomy radiotherapy (PMRT). We assessed national trends and patterns of utilization of hypofractionated PMRT. Women ≥18 years with breast cancer treated with mastectomy and PMRT to the chest wall with or without regional lymph nodes from 2004-2014 were identified from the National Cancer Database. A standard fractionation cohort was defined as patients receiving 180–200 cGy per fraction to a total dose of 4500–7000 cGy over 5–7 weeks, and a hypofractionation cohort was defined as those receiving 250–400 cGy per fraction to a total dose of 3000–6000 cGy over 2–5 weeks. Multivariable logistic regression was used to determine factors associated with hypofractionated PMRT use. 113,981 patients met study criteria. Overall, hypofractionated PMRT use was low (1.1%) though utilization increased over time (p≤0.001). Older age, greater comorbidity, further distance from treatment facility, treatment at academic facilities, less extensive disease, and recent treatment year were statistically significant predictors of hypofractionation use compared to standard fractionation. Conversely, breast reconstruction and receipt of chemotherapy were negative predictors. Given the absence of high-level evidence to support its use, hypofractionated PMRT was uncommonly utilized in the US from 2004–2014, though a small increase in use was noted over time. Findings from this study may be useful in designing future studies, and may serve as a baseline for evaluation of future changes in practice patterns. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103917/pdf http://www.clinical-breast-cancer.com/article/S1526820917307735/pdf |
| Ending Page | e908 |
| Page Count | 10 |
| Starting Page | e899 |
| ISSN | 15268209 |
| e-ISSN | 19380666 |
| DOI | 10.1016/j.clbc.2018.02.009 |
| Journal | Clinical breast cancer |
| Issue Number | 5 |
| Volume Number | 18 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-02-20 |
| Access Restriction | Open |
| Subject Keyword | Journal: Clinical breast cancer Radiology, Nuclear Medicine and Imaging Post-mastectomy Radiotherapy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
