Factors Affecting Radiotherapy Prescribing Patterns in the Post-Mastectomy Setting

Current Oncology - Tập 25 Số 2 - Trang 146-151
Theodora Koulis1,2,3, Amit Dang4, Caroline Speers5, Robert Olson1,3
1BC Canc Ctr North, Dept Radiat Oncol, Prince George, BC, Canada
2BC Canc Sindi Ahluwalia Hawkins Ctr Southern Inte, Dept Radiat Oncol, Kelowna, BC, Canada
3Univ British Columbia, Dept Surg, Vancouver, BC, Canada
4Univ British Columbia, Sch Med, Prince George, BC, Canada
5Vancouver Ctr, BC Canc Breast Canc Outcomes Unit, Vancouver, BC, Canada

Tóm tắt

Background: Radiation 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. Methods: Women 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. Results: Of 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.

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Current Oncology

Tập 25 Số 2

146-151

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