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How consistent is breast boost radiotherapy practice across the United Kingdom?

Published online by Cambridge University Press:  12 December 2016

Sophia Magwaro
Sophia Magwaro*
Affiliation:
Radiotherapy Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Correspondence to: Sophia Magwaro, Radiotherapy Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 9RF, UK. Tel: 02033110291; E-mail: Sophia.Magwaro@imperial.nhs.uk
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Abstract

Purpose

The aims of this project were to identify the national range of breast boost radiotherapy doses and variations in treatment practice; determine the factors that potentially cause variations; and examine whether differences between regions are based on clinical evidence or access to technical and financial resources by surveying Therapeutic Radiographers across the United Kingdom to determine current radiotherapy boost practice.

Methods

A cross-sectional study design was selected. An electronic questionnaire using the website Survey Monkey® tool was utilised to collect categorical data from practicing Therapeutic Radiographers within the United Kingdom.

Setting

Participants were invited to participate from radiotherapy departments across the four countries of the United Kingdom (England, Scotland, Wales and Northern Ireland). There are 52 radiotherapy departments across 12 regions of the United Kingdom.

Results

In total, 34 Therapeutic Radiographers participated. Their responses were grouped according to their region of practice. Results indicated that there are ten different dose schedules offered to patients nationally for the treatment of breast boost, with 77% of respondents using electrons to deliver boost radiotherapy.

Conclusions

There is no general consensus among Therapeutic Radiographers about whether factors such as age, tumour size, tumour grade or the presence of negative or positive margins, influence the therapeutic doses prescribed for different patients. This may be attributed to the absence of clinical research evidence to support evidence-based practice.

Keywords

breast boost radiotherapytherapeutic radiographerssurveyclinical research
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 1 , March 2017 , pp. 13 - 19
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Copyright
© Cambridge University Press 2016 

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References

1. National Collaborating Centre for Cancer. Early and locally advanced breast cancer diagnosis and treatment NICE clinical guidelines, No. 80 National Collaborating Centre for Cancer (UK). Cardiff: National Collaborating Centre for Cancer (UK); Chapter 6.5 February 2009. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0005377/. Accessed on 20th July 2015.Google Scholar
2. Whelan, T, Mackenzie, R, Julian, J et al. Randomised trial of breast irradiation schedules after lumpectomy for women with lymph node negative breast cancer. J Natl Cancer Inst 2002; 94 (15): 1143–1150.CrossRefGoogle ScholarPubMed
3. Haviland, J S, Owen, J R, Dewar, J A et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol 2013; 14 (11): 1086–1094.Google Scholar
4. Clarke, M, Collins, R, Darby, S et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 366 (9503): 2087–2106.Google Scholar
5. Bartelink, H, Horiot, J C, Poortmans, P M et al. Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol 2007; 25 (22): 3259–3265.Google Scholar
6. Bartelink, H, Horiot, J C, Poortmans, P et al. Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 2001; 345 (19): 1378–1387.Google Scholar
7. Toulba, A, Iraqi, M, Mouhajir, N et al. The additional irradiation of the tumor bed ‘The Boost’ in the breast cancer conservative treatment: what techniques? J Nucl Med Radiat Ther 2015; 6: 1.Google Scholar
8. Guenzi, M, Vagge, S, Azinwi, NC et al. A biologically competitive 21 days hypofractionation scheme with weekly concomitant boost in breast cancer radiotherapy feasibility acute sub-acute and short term late effects. Radiat Oncol 2010; 5: 111.Google Scholar
9. Omlin, A, Amichetti, M, Azria, D et al. Boost radiotherapy in young women with ductal carcinoma in situ: a multicentre, retrospective study of the Rare Cancer Network. Lancet Oncol 2006; 7: 652–656.Google Scholar
10. Hurkmans, C W, Meijer, G J, van Vliet-Vroegindeweij, C, van der Sangen, M J, Cassee, J. High-dose simultaneously integrated breast boost using intensity-modulated radiotherapy and inverse optimization. Int J Radiat Oncol Biol Phys 2006; 6 (3): 923–930.Google Scholar
11. Benda, R K, Yasuda, G, Sethi, A, Gabram, S G A, Hinerman, R W, Mendenhall, N P. Breast boost: are we missing the target? Feb 2003. Cancer 97: 905–909.Google Scholar
12. Royal College of Radiologists. Radiotherapy Dose-Fractionation, 2006, London, Royal College of Radiologists. http://rcr.ac.uk/docs/oncology/pdf/Dose-Fractionation_Final.pdf. Accessed on 8th January 2014.Google Scholar
13. Romestaing, P, Lehingue, Y, Carrie, C et al. Role of a 10-Gy boost in the conservative treatment of early breast cancer: results of a randomized clinical trial in Lyon, France. J Clin Oncol 15 (3): 963–968.Google Scholar
14. Poortmans, P, Bartelink, H, Horiot, J C et al. The influence of the boost technique on local control in breast conserving treatment in the EORTC ‘boost versus no boost’ randomised trial. Radiother Oncol 2004; 72 (1): 25–33.Google Scholar
15. Krawczyk, J J, Engel, B. The importance of surgical clips for adequate tangential beam planning in breast conserving surgery and irradiation. Int J Radiat Oncol Biol Phys 1999; 43: 347–350.Google Scholar