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ABSTRACT: Purpose
The details of breast reconstruction and radiation therapy (RT) vary between institutions; therefore, we sought to investigate the practice patterns of radiation oncologists who specialize in breast cancer.Materials and methods
We identified the practice patterns and inter-hospital variations from a multi-center cohort of women with breast cancer who underwent post-mastectomy RT (PMRT) to the reconstructed breast at 16 institutions between 2015 and 2016. The institutions were requested to contour the target volume and produce RT plans for one representative case with five different clinical scenarios and answer questionnaires which elicited infrastructural information. We assessed the inter-institutional variations in RT in terms of the target, normal organ delineation, and dose-volume histograms.Results
Three hundred fourteen patients were included; 99% of them underwent immediate reconstruction. The most irradiated material was tissue expander (36.9%) followed by transverse rectus abdominis musculocutaneous flap (23.9%) and silicone implant (12.1%). In prosthetic-based reconstruction with tissue expander, most patients received PMRT following partial deflation. Conventional fractionation and hypofractionation RT were used in 66.6% and 33.4% patients, respectively (commonest: 40.05 Gy in 15 fractions [17.5%]). Furthermore, 15.6% of the patients received boost RT and 53.5% were treated with bolus. Overall, 15 physicians responded to the questionnaires and six submitted their contours and RT plans. There was a significant variability in target delineations and RT plans between physicians, and between clinical scenarios.Conclusion
Adjuvant RT following post-mastectomy reconstruction has become a common practice in Korea. The details vary significantly between institutions, which highlights an urgent need for standard protocol in this clinical setting.
SUBMITTER: Yang G
PROVIDER: S-EPMC7785842 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
Yang Gowoon G Chang Jee Suk JS Shin Kyung Hwan KH Kim Jin Ho JH Park Won W Kim Haeyoung H Kim Kyubo K Lee Ik Jae IJ Yoon Won Sup WS Cha Jihye J Lee Kyu-Chan KC Kim Jin Hee JH Choi Jin Hwa JH Ahn Sung-Ja SJ Ha Boram B Lee Sun Young SY Lee Dong Soo DS Lee Jeongshim J Shin Sei One SO Kim Yong Bae YB
Radiation oncology journal 20201216 4
<h4>Purpose</h4>The details of breast reconstruction and radiation therapy (RT) vary between institutions; therefore, we sought to investigate the practice patterns of radiation oncologists who specialize in breast cancer.<h4>Materials and methods</h4>We identified the practice patterns and inter-hospital variations from a multi-center cohort of women with breast cancer who underwent post-mastectomy RT (PMRT) to the reconstructed breast at 16 institutions between 2015 and 2016. The institutions ...[more]