Increasing use of post‐mastectomy hypofractionated radiation therapy for breast cancer in Victoria. Issue 3 (22nd November 2021)

• Record Type: Journal Article
• Authors: Kim, Sohyun; Pitson, Graham; Koh, Tze Lui; Chao, Michael; Byrne, Keelan; Hornby, Colin; Foroudi, Farshad; Millar, Jeremy; Ong, Wee Loon
• Is Part Of: Journal of medical imaging and radiation oncology. Volume 66:Issue 3(2022)
• Page Start: 428
• Page End: 435
• Publication Date: 2021-11-22
• Subjects: breast cancer -- hypofractionation -- post mastectomy -- radiation therapy; Radiology, Medical -- Periodicals; Radiology, Medical -- Australasia -- Periodicals; 616.0757
• DOI: 10.1111/1754-9485.13354
• Languages: English
• ISSNs: 1754-9477

Abstract

Abstract: Introduction: The aim of this study was to evaluate the use of post‐mastectomy hypofractionationed radiation therapy (HFRT) for breast cancer in Victoria, Australia. Methods: 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. Results: 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. Conclusion: 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.