Present clinical practice of breast cancer radiotherapy in Italy: a nationwide survey by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) Breast Group
- 20 February 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in La radiologia medica
- Vol. 125 (7), 674-682
- https://doi.org/10.1007/s11547-020-01147-5
Abstract
Aims To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT). Methods A nationwide, 21-point questionnaire was distributed online via SurveyMonkey. Results Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BC patients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery. Conclusions This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.Keywords
This publication has 48 references indexed in Scilit:
- DEGRO practical guidelines: radiotherapy of breast cancer IStrahlentherapie und Onkologie, 2013
- Predictors of Locoregional Recurrence After Neoadjuvant Chemotherapy: Results From Combined Analysis of National Surgical Adjuvant Breast and Bowel Project B-18 and B-27Journal of Clinical Oncology, 2012
- Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trialsThe Lancet, 2011
- True Recurrence Versus New Primary: An Analysis of Ipsilateral Breast Tumor Recurrences After Breast-Conserving TherapyInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Exeresis and Brachytherapy as Salvage Treatment for Local Recurrence After Conservative Treatment for Breast Cancer: Results of a Ten-Year Pilot StudyInternational Journal of Radiation Oncology*Biology*Physics, 2010
- Postmastectomy Radiation Therapy for Patients With Locally Advanced Breast CancerSeminars in Radiation Oncology, 2009
- Introduction: Locally Advanced Breast CancerSeminars in Radiation Oncology, 2009
- Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapyBMC Cancer, 2007
- Postmastectomy Radiation Improves the Outcome of Patients With Locally Advanced Breast Cancer Who Achieve a Pathologic Complete Response to Neoadjuvant ChemotherapyInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Postmastectomy Radiation Improves Local-Regional Control and Survival for Selected Patients With Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy and MastectomyJournal of Clinical Oncology, 2004