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Title: Increasing use of post-mastectomy hypofractionated radiation therapy for breast cancer in Victoria.
Austin Authors: Kim, Sohyun;Pitson, Graham;Koh, Tze Lui ;Chao, Michael ;Byrne, Keelan;Hornby, Colin;Foroudi, Farshad ;Millar, Jeremy;Ong, Wee Loon 
Affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Alfred Health Radiation Oncology, Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
School of Clinical Medicine, University of Cambridge, Cambridge, UK
Victorian Department of Health, Melbourne, Victoria, Australia
Department of Radiation Oncology, Barwon Health, Geelong, Victoria, Australia
Department of Radiation Oncology, Chris O'Brien Life House, Camperdown, New South Wales, Australia
Radiation Oncology
Genesis Cancer Care, Ringwood, Victoria, Australia
Olivia Newton-John Cancer Wellness and Research Centre
Issue Date: 2022
Date: 2021-11-22
Publication information: Journal of medical imaging and radiation oncology 2022-04; 66(3): 428-435
Abstract: The aim of this study was to evaluate the use of post-mastectomy hypofractionationed radiation therapy (HFRT) for breast cancer in Victoria, Australia. This is a population-based cohort of women with breast cancer who received post-mastectomy RT to the chest wall with or without nodal irradiation between 2012 and 2017. HFRT was defined as <25 fractions of RT. Data were captured in the Victorian Radiotherapy Minimum Dataset (VRMDS). The changing pattern of HFRT use was evaluated using the Cochran-Armitage test. Patient-, treatment- and institutional-related factors associated with HFRT use were evaluated using multivariable logistic regression. Two thousand and twenty-one women were included in this study, of which 238 (12%) received HFRT. This increased from 8% in 2012 to 18% in 2017 (P-trend < 0.001). Older women were more likely to have HFRT (26% in women above 70 years vs 6% in women under 50 years; P < 0.001). Women who did not have nodal irradiation were more likely to have HFRT than those who did (18% vs 9% respectively; P < 0.001). In multivariate analyses, the progressive increase in HFRT use over time remained statistically significant - women treated in 2017 were four times more likely to receive HFRT than those treated in 2012 (95% CI = 2.1-7.7; P < 0.001). Other factors independently associated with increased likelihood of HFRT use included increasing age at RT, and lack of nodal irradiation. In this first Australian study evaluating the use of post-mastectomy HFRT, we observed increasing HFRT use in Victoria over time. We anticipate this rising trend will continue in the coming years.
DOI: 10.1111/1754-9485.13354
ORCID: 0000-0001-8202-8602
Journal: Journal of Medical Imaging and Radiation Oncology
PubMed URL: 34811941
Type: Journal Article
Subjects: breast cancer
post mastectomy
radiation therapy
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