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Hypo- vs. normofractionated radiation therapy in breast cancer: A patterns of care analysis in German speaking countries


Mayinger, Michael; Straube, C; Habermehl, D; Duma, M N; Combs, Stephanie E (2020). Hypo- vs. normofractionated radiation therapy in breast cancer: A patterns of care analysis in German speaking countries. Reports of Practical Oncology and Radiotherapy, 25:775-779.

Abstract

Aim and background: To assess the use of hypofractionated (HG-RT) versus normofractionated radiation therapy (NF-RT) in Breast Cancer in German speaking countries.
Materials and methods: Between July 2017 and August 2017, an email-based survey was sent to all 1408 physicians that are members of the German Society of Radiation Oncology (DEGRO). The survey was completed by 180 physicians including 10 private practic owners and 52 heads of departments. The majority (82.1%) of the participants had >15 years of experience in radiation therapy (RT).
Results: The majority (83.9%) of the heads of the departments agreed on using the normofractionated regimen of RT as standard treatment for breast cancer. Several physicians were skeptical about HF-RT with 6.5% of the heads refusing to use HF-RT. 40.3% of the departments had not seen the new German guidelines suggesting HF-RT as the standard treatment for all patients as positive or merely adopted neutral position toward the guidelines (33.9%). The main points of criticism were increased side effects, an impaired toxicity profile and insufficient data. Most departments (46.8%) that perform HF-RT do so in an individual based manner.
Conclusions: HF-RT remains controversial in German speaking countries. Our data shows that NF-RT remains the predominant method of treatment. HF-RT is only used in a defined group of patients as most German physicians agree that particular patients, especially those at higher risk of RT late effects, may benefit from a less intense, extended fractionation schedule.

Abstract

Aim and background: To assess the use of hypofractionated (HG-RT) versus normofractionated radiation therapy (NF-RT) in Breast Cancer in German speaking countries.
Materials and methods: Between July 2017 and August 2017, an email-based survey was sent to all 1408 physicians that are members of the German Society of Radiation Oncology (DEGRO). The survey was completed by 180 physicians including 10 private practic owners and 52 heads of departments. The majority (82.1%) of the participants had >15 years of experience in radiation therapy (RT).
Results: The majority (83.9%) of the heads of the departments agreed on using the normofractionated regimen of RT as standard treatment for breast cancer. Several physicians were skeptical about HF-RT with 6.5% of the heads refusing to use HF-RT. 40.3% of the departments had not seen the new German guidelines suggesting HF-RT as the standard treatment for all patients as positive or merely adopted neutral position toward the guidelines (33.9%). The main points of criticism were increased side effects, an impaired toxicity profile and insufficient data. Most departments (46.8%) that perform HF-RT do so in an individual based manner.
Conclusions: HF-RT remains controversial in German speaking countries. Our data shows that NF-RT remains the predominant method of treatment. HF-RT is only used in a defined group of patients as most German physicians agree that particular patients, especially those at higher risk of RT late effects, may benefit from a less intense, extended fractionation schedule.

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Additional indexing

Item Type:Journal Article, not_refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Oncology
Health Sciences > Radiology, Nuclear Medicine and Imaging
Uncontrolled Keywords:Breast cancer; Patterns of care; Hypofractionated radiotherapy; Normofractionated radiotherapy
Language:English
Date:1 September 2020
Deposited On:08 Jan 2021 09:31
Last Modified:09 Jan 2021 21:01
Publisher:Elsevier
ISSN:1507-1367
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.rpor.2020.07.003
PubMed ID:32904392

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