Evidence-based guidelines for hypofractionated radiation in breast cancer : conclusions of the Catalan expert working group
Eraso, Arantxa (Institut Català d'Oncologia (Girona, Catalunya). Radiation Oncology Department)
Sanz, Javier (Hospital del Mar (Barcelona, Catalunya))
Mollà, Meritxell (Hospital Clínic i Provincial de Barcelona)
Reyes López, Victoria (Hospital Universitari Vall d'Hebron)
Pedro, Agustí (Institut d'Investigació Biomèdica Sant Pau)
Arenas Prat, Meritxell (Hospital Universitari Sant Joan de Reus (Tarragona))
Martinez, Evelyn (Institut Català d'Oncologia. Hospital Duran i Reynals. Servei d'Oncologia Radioteràpica)
Ballester Alabau, Rosa María (Institut Català d'Oncologia)
Cambra, Maria José (Hospital General de Catalunya. Servei d'Oncologia Radioteràpica)
García, Virginia (Hospital Universitari Arnau de Vilanova)
Prades, Joan Lluis (Pla Director d'Oncologia de Catalunya. Institut Català d'Oncologia. Hospital Duran i Reynals)
Borras, Josep M. (Pla Director d'Oncologia de Catalunya. Institut Català d'Oncologia. Hospital Duran i Reynals)
Algara, Manuel (Institut Hospital del Mar d'Investigacions Mèdiques)

Date:	2022
Abstract:	Introduction: Daily, moderate hypofractionation has become standard treatment for breast cancer following breast-conserving surgery, although substantial variation exists in its use. This paper describes the generation of consensus-based recommendations for the utilisation of this therapy at the healthcare system level and compares these to American Society for Radiation Oncology (ASTRO) guidelines. Materials and methods: Consensus-based guidelines were developed in three steps, including a systematic literature review and involvement of radiation oncologists specialising in breast cancer in Catalonia: (a) creation of a working group and evidence review; (b) consideration of the levels of evidence and agreement on the formulation of survey questions; and (c) performance of survey and development of consensus-based recommendations. Results were compared to the ASTRO recommendations. Results: Consensus was above 80% for 10 of the 14 survey items. Experts supported hypofractionated radiotherapy for all breast cancer patients aged 40 years or more; with invasive carcinoma and breast-conserving surgery; without radiation of lymph nodes; and regardless of the tumour size, histological grade, molecular subtype, breast size, laterality, other treatment characteristics, or need for a boost. Over half favoured its use in all situations, even where available scientific evidence is insufficient. The resulting recommendations and the quality of the evidence are comparable to those from ASTRO, despite some differences in the degree of consensus. Conclusion: Specialists agree that hypofractionation is the standard treatment for breast cancer following breast-conserving surgery, but some specific areas require a higher level of evidence before unequivocally extending indications.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Breast cancer ; Radiotherapy ; Hypofractionation
Published in:	Clinical & translational oncology, Vol. 24 Núm. 8 (august 2022) , p. 1580-1587, ISSN 1699-3055

DOI: 10.1007/s12094-022-02798-8
PMID: 35190961

8 p, 998.3 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles