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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Has Hypofractionated Whole-Breast Radiation Therapy Become the Standard of Care in the United States? An Updated Report from National Cancer Database
CLINICAL BREAST CANCER, v 22(1), pE8
Jan 2022
PMID: 34257001
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Using the National Cancer Database from 2004-2016, we evaluated the trend of hypofractionated whole breast radiation therapy (HF-WBI) utilization and factors associated with utilization. Utilization in the United States has more than doubled from 2013 to 2016, but it has not become the standard of care. We identified several patient and facility factors that impact the uptake of HF-WBI treatment. Introduction/Background: We aimed to update the previous evaluation of hypofractionated whole-breast irradiation (HF-WBI) use over time in the United States and factors related to its adoption for patients undergoing a lumpectomy from 2004 to 2016. Materials and Methods: Among the patients who underwent a lumpectomy, we identified 688,079 patients with early-stage invasive breast cancer and 248,218 patients with ductal carcinoma in situ in the National Cancer Database from 2004 to 2016. We defined HF-WBI as 2.5 to 3.33 Gy/fraction to the breast and conventional fractionated whole-breast irradiation as 1.8 to 2.0 Gy/fraction. We evaluated the trend of HF-WBI use and examined factors associated with HF-WBI use using logistic regression models. Results: Among invasive cancer patients, the use of HF-WBI increased exponentially from 0.7% in 2004 to 15.6% in 2013 and then to 38.1% in 2016. Among patients with ductal carcinoma in situ, the use of HF-WBI has increased significantly from 0.42% in 2004 to 13.4% in 2013 and then to 34.3% in 2016. Factors found to be associated with HF-WBI use included age, patient geographical location, race/ethnicity, tumor stage, grade, treating facility type, and volume. Conclusion: HF-WBI use in the United States has more than doubled from 2013 to 2016. Although its use is close to that of conventional fractionated whole-breast irradiation, HF-WBI is still far from the preferred standard of care in the United States. We identified several patient and facility factors that can impact the uptake of HF-WBI treatment. Microabstract Using the National Cancer Database from 2004 to 2016, we evaluated the trend of hypofractionated whole-breast radiation therapy use and factors associated with use. Use in the United States has more than doubled from 2013 to 2016, but it has not become the standard of care. We identified several patient and facility factors that impact the uptake of hypofractionated whole-breast radiation therapy treatment. (C) 2021 Elsevier Inc. All rights reserved.
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Details
- Title
- Has Hypofractionated Whole-Breast Radiation Therapy Become the Standard of Care in the United States? An Updated Report from National Cancer Database
- Publication Details
- CLINICAL BREAST CANCER, v 22(1), pE8
- Publisher
- CIG MEDIA GROUP, LP; DALLAS
- Grant note
- This research was partially supported by the Breast Cancer Research Foundation (BCRF-20-071) and Agency for Healthcare Research and Quality (R03 HS025806). The National Cancer Database (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC's NCDB and the hospitals participating in the CoC NCDB are the source of the deidentified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000740907700014
- Scopus ID
- 2-s2.0-85110498234
- Other Identifier
- 991021861168404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology