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乳腺癌术后适度大分割放射治疗:拉丁美洲和加勒比地区国家放射肿瘤学家的偏好

Moderately hypofractionated post-operative radiation therapy for breast cancer: preferences amongst radiation oncologists from countries in Latin America and the Caribbean.

作者信息

Marta Gustavo Nader, Moraes Fabio Y, de Oliveira Franco Rejane Carolina, de Andrade Carvalho Heloísa, Gouveia André Guimaraes, de Lima Gössling Gustavo Cartaxo, de Jesus Rafaela Gomes, Ferraris Gustavo, Schuffenegger Pablo Munoz, Bardales Gustavo Sarria, Chacón María Adela Poitevin, Murillo Raúl, Sánchez Luis Ernesto Moreno, Gamarra-Cabezas Elizabeth, Rosa Arthur Accioly, da Silva Maurício Fraga, de Mattos Marcos Duarte, Morais Diego Chaves Rezende, de Castro Douglas Guedes, Dal Pra Alan, Amêndola Beatriz E, Barros José Máximo, Lara Tomas Merino, Isa Nicolás, de la Mata Moya Dolores, Hidalgo Iván, Velilla Diego Gimenez, Loayza Lijia Elizabeth Avilés, Montenegro Francisco Gomez, Sanchez Chacin Nestor O, Werutsky Gustavo, Viani Gustavo Arruda

机构信息

Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil.

Latin American Cooperative Oncology Group (LACOG), Brazil.

出版信息

Rep Pract Oncol Radiother. 2023 Jul 25;28(3):340-351. doi: 10.5603/RPOR.a2023.0046. eCollection 2023.

Abstract

BACKGROUND

The safety and effectiveness of moderately hypofractionated post-operative radiation therapy for breast cancer were demonstrated by several trials. This study aimed to evaluate the current patterns of practice and prescription preference about moderately hypofractionated post-operative radiation therapy to assess possible aspects that affect the decision-making process regarding the use of fractionation in breast cancer patients in Latin America and the Caribbean (LAC). We also aimed to identify factors that can restrain the utilization of moderately hypofractionated post-operative radiation therapy for breast cancer.

MATERIALS AN METHODS

Radiation oncologists from LAC were invited to contribute to this study. A 38-question survey was used to evaluate their opinions.

RESULTS

A total of 173 radiation oncologists from 13 countries answered the questionnaire. The majority of respondents (84.9%) preferred moderately hypofractionated post-operative radiation therapy as their first choice in cases of whole breast irradiation. Whole breast plus regional nodal irradiation, post-mastectomy (chest wall and regional nodal irradiation) without reconstruction, and post-mastectomy (chest wall and regional node irradiation) with reconstruction hypofractionated post-operative radiation therapy was preferred by 72.2% 71.1%, and 53.7% of respondents, respectively. Breast cancer stage, and flap-based breast reconstruction were the factors associated with absolute contraindications for the use of hypofractionated schedules.

CONCLUSION

Even though moderately hypofractionated post-operative radiation therapy for breast cancer is considered a new standard to the vast majority of the patients, its unrestricted application in clinical practice across LAC still faces reluctance.

摘要

背景

多项试验证明了乳腺癌术后适度大分割放疗的安全性和有效性。本研究旨在评估乳腺癌术后适度大分割放疗的当前实践模式和处方偏好,以评估可能影响拉丁美洲和加勒比地区(LAC)乳腺癌患者分割使用决策过程的方面。我们还旨在确定能够限制乳腺癌术后适度大分割放疗使用的因素。

材料与方法

邀请LAC的放射肿瘤学家参与本研究。使用一份包含38个问题的调查问卷来评估他们的意见。

结果

来自13个国家的173名放射肿瘤学家回答了问卷。大多数受访者(84.9%)在全乳照射的情况下首选适度大分割术后放疗。在全乳加区域淋巴结照射、乳房切除术后(胸壁和区域淋巴结照射)未进行重建以及乳房切除术后(胸壁和区域淋巴结照射)进行重建的情况下,分别有72.2%、71.1%和53.7%的受访者首选大分割术后放疗。乳腺癌分期和皮瓣乳房重建是与使用大分割方案的绝对禁忌症相关的因素。

结论

尽管乳腺癌术后适度大分割放疗被大多数患者视为新标准,但其在LAC临床实践中的无限制应用仍面临阻力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55bd/10547413/867eb490593d/rpor-28-3-340f1.jpg

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