Sistema de Salut de Catalunya
Institut Català de la Salut
[Eraso A] Radiation Oncology Department, Institut Català d’Oncologia Girona, Girona, Spain. [Sanz J] Radiation Oncology Department, Hospital del Mar, Barcelona, Spain. [Mollà M] Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona, Spain. [Reyes V] Servei d’Oncologia Radioteràpica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Pedro A] Radiation Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Arenas M] Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Reus, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-09-09T12:18:19Z
2022-09-09T12:18:19Z
2022-08
Breast cancer; Hypofractionation; Radiotherapy
Càncer de mama; Hipofraccionament; Radioteràpia
Cáncer de mama; Hipofraccionamiento; Radioterapia
Introduction Daily, moderate hypofractionation has become standard treatment for breast cancer following breast-conserving surgery, although substantial variation exists in its use. This paper describes the generation of consensus-based recommendations for the utilisation of this therapy at the healthcare system level and compares these to American Society for Radiation Oncology (ASTRO) guidelines. Materials and methods Consensus-based guidelines were developed in three steps, including a systematic literature review and involvement of radiation oncologists specialising in breast cancer in Catalonia: (a) creation of a working group and evidence review; (b) consideration of the levels of evidence and agreement on the formulation of survey questions; and (c) performance of survey and development of consensus-based recommendations. Results were compared to the ASTRO recommendations. Results Consensus was above 80% for 10 of the 14 survey items. Experts supported hypofractionated radiotherapy for all breast cancer patients aged 40 years or more; with invasive carcinoma and breast-conserving surgery; without radiation of lymph nodes; and regardless of the tumour size, histological grade, molecular subtype, breast size, laterality, other treatment characteristics, or need for a boost. Over half favoured its use in all situations, even where available scientific evidence is insufficient. The resulting recommendations and the quality of the evidence are comparable to those from ASTRO, despite some differences in the degree of consensus. Conclusion Specialists agree that hypofractionation is the standard treatment for breast cancer following breast-conserving surgery, but some specific areas require a higher level of evidence before unequivocally extending indications.
Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.
Article
Published version
English
Radiació - Dosificació; Mastectomia; Mama - Càncer - Radioteràpia; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Radiotherapy::Radiotherapy Dosage::Dose Fractionation, Radiation::Radiation Dose Hypofractionation; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Mastectomy::Mastectomy, Segmental; DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms; Other subheadings::Other subheadings::Other subheadings::/radiotherapy; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::radioterapia::dosificación radioterapéutica::fraccionamiento de la dosis de radiación::hipofraccionamiento de la dosis de radiación; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::mastectomía::mastectomía segmentaria; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama; Otros calificadores::Otros calificadores::Otros calificadores::/radioterapia
Springer
Clinical and Translational Oncology;24
https://doi.org/10.1007/s12094-022-02798-8
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
