Factors affecting radiotherapy prescribing patterns in the post-mastectomy setting

Current oncology

C. Speers¹  A. Dang²  T.A. Koulis³  R.A. Olson⁴ 

[1] BC Cancer–Sindi Ahluwalia Hawkins Centre for the Southern Interior;University of British Columbia;BC Cancer–Centre for the North;University of British Columbia School of Medicine;Vancouver Centre

关键词: Breast cancer;    radiation therapy;    fractionation;    mastectomy;    reconstruction;   

DOI  :  10.3747/co.25.3773

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

BackgroundRadiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction. MethodsWomen diagnosed with stages 0–iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a clinicopathology database. Patient demographic, tumour, and treatment information were extracted. Of the identified patients, those undergoing mastectomy were the focus of the present analysis. ResultsOf 4016 patients identified, 1143 (28%) underwent mastectomy. The patients treated with mastectomy had a median age of 57 years, and 37% of them underwent reconstruction. Treatment with more than 16 fractions of rt was associated with autologous reconstruction [odds ratio (or): 37.2; 95% confidence interval (ci): 11.2 to 123.7;p< 0.001], implant reconstruction (or: 93.3; 95% ci: 45.3 to 192.2;p< 0.001), and treating centre. Hypofractionated treatment was associated with older age (or: 0.94; 95% ci: 0.92 to 0.96;p< 0.001), and living more than 400 km from a treatment centre (or: 0.37; 95% ci: 0.16 to 0.86;p= 0.02). Conclusions Prescribing practices in breast cancer patients undergoing mastectomy are influenced by reconstruction intent, age, nodal status, and distance from the treatment centre. Those factors should be considered when making treatment decisions.

【 授权许可】

Unknown