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Title: The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012

Abstract

Purpose: Increasing phase 3 evidence has been published about the safety and efficacy of hypofractionated radiation therapy, in comparison with standard fractionation, in early-stage, node-negative breast cancer. However, uptake of hypofractionation has not been universal. The aim of this study was to investigate the hypofractionation regimen variations in practice across public radiation oncology facilities in New South Wales (NSW). Methods and Materials: Patients with early breast cancer registered in the NSW Clinical Cancer Registry who received radiation therapy for early-stage breast cancer in a publicly funded radiation therapy department between 2008 and 2012 were identified. Data extracted and analyzed included dose and fractionation type, patient age at first fraction, address (for geocoding), year of diagnosis, year of treatment, laterality, and department of treatment. A logistic regression model was used to identify factors associated with fractionation type. Results: Of the 5880 patients fulfilling the study criteria, 3209 patients (55%) received standard fractionation and 2671 patients (45%) received hypofractionation. Overall, the use of hypofractionation increased from 37% in 2008 to 48% in 2012 (range, 7%-94% across departments). Treatment facility and the radiation oncologist prescribing the treatment were the strongest independent predictors of hypofractionation. Weaker associations were also found for age, tumor sitemore » laterality, year of treatment, and distance to facility. Conclusions: Hypofractionated regimens of whole breast radiation therapy have been variably administered in the adjuvant setting in NSW despite the publication of long-term trial results and consensus guidelines. Some factors that predict the use of hypofractionation are not based on guideline recommendations, including lower rates of left-sided treatment and increasing distance from a treatment facility.« less

Authors:
 [1];  [2];  [2];  [2];  [3]; ; ; ;  [4]
  1. Liverpool Cancer Therapy Centre, Liverpool, New South Wales (Australia)
  2. (Australia)
  3. Peter MacCallum Cancer Centre, Melbourne (Australia)
  4. New South Wales Cancer Institute (Australia)
Publication Date:
OSTI Identifier:
22645640
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 2; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FRACTIONATED IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; RADIOTHERAPY; RECOMMENDATIONS

Citation Formats

Delaney, Geoff P., E-mail: Geoff.delaney@swsahs.nsw.gov.au, Collaboration for Cancer Outcomes Research and Evaluation, University of New South Wales, Sydney, Ingham Health and Medical Research Institute, Sydney, New South Wales Cancer Institute, Gandhidasan, Senthilkumar, Walton, Richard, Terlich, Frances, Baker, Deborah, and Currow, David. The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.05.016.
Delaney, Geoff P., E-mail: Geoff.delaney@swsahs.nsw.gov.au, Collaboration for Cancer Outcomes Research and Evaluation, University of New South Wales, Sydney, Ingham Health and Medical Research Institute, Sydney, New South Wales Cancer Institute, Gandhidasan, Senthilkumar, Walton, Richard, Terlich, Frances, Baker, Deborah, & Currow, David. The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012. United States. doi:10.1016/J.IJROBP.2016.05.016.
Delaney, Geoff P., E-mail: Geoff.delaney@swsahs.nsw.gov.au, Collaboration for Cancer Outcomes Research and Evaluation, University of New South Wales, Sydney, Ingham Health and Medical Research Institute, Sydney, New South Wales Cancer Institute, Gandhidasan, Senthilkumar, Walton, Richard, Terlich, Frances, Baker, Deborah, and Currow, David. Sat . "The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012". United States. doi:10.1016/J.IJROBP.2016.05.016.
@article{osti_22645640,
title = {The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012},
author = {Delaney, Geoff P., E-mail: Geoff.delaney@swsahs.nsw.gov.au and Collaboration for Cancer Outcomes Research and Evaluation, University of New South Wales, Sydney and Ingham Health and Medical Research Institute, Sydney and New South Wales Cancer Institute and Gandhidasan, Senthilkumar and Walton, Richard and Terlich, Frances and Baker, Deborah and Currow, David},
abstractNote = {Purpose: Increasing phase 3 evidence has been published about the safety and efficacy of hypofractionated radiation therapy, in comparison with standard fractionation, in early-stage, node-negative breast cancer. However, uptake of hypofractionation has not been universal. The aim of this study was to investigate the hypofractionation regimen variations in practice across public radiation oncology facilities in New South Wales (NSW). Methods and Materials: Patients with early breast cancer registered in the NSW Clinical Cancer Registry who received radiation therapy for early-stage breast cancer in a publicly funded radiation therapy department between 2008 and 2012 were identified. Data extracted and analyzed included dose and fractionation type, patient age at first fraction, address (for geocoding), year of diagnosis, year of treatment, laterality, and department of treatment. A logistic regression model was used to identify factors associated with fractionation type. Results: Of the 5880 patients fulfilling the study criteria, 3209 patients (55%) received standard fractionation and 2671 patients (45%) received hypofractionation. Overall, the use of hypofractionation increased from 37% in 2008 to 48% in 2012 (range, 7%-94% across departments). Treatment facility and the radiation oncologist prescribing the treatment were the strongest independent predictors of hypofractionation. Weaker associations were also found for age, tumor site laterality, year of treatment, and distance to facility. Conclusions: Hypofractionated regimens of whole breast radiation therapy have been variably administered in the adjuvant setting in NSW despite the publication of long-term trial results and consensus guidelines. Some factors that predict the use of hypofractionation are not based on guideline recommendations, including lower rates of left-sided treatment and increasing distance from a treatment facility.},
doi = {10.1016/J.IJROBP.2016.05.016},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 96,
place = {United States},
year = {Sat Oct 01 00:00:00 EDT 2016},
month = {Sat Oct 01 00:00:00 EDT 2016}
}