TY - JOUR
T1 - Original Radiotherapy after primary CHEMotherapy (RAPCHEM)
T2 - Practice variation in a Dutch registration study (BOOG 2010-03)
AU - Boersma, Liesbeth J.
AU - Verloop, Janneke
AU - Voogd, Adri C.
AU - Elkhuizen, Paula H. M.
AU - Houben, Ruud
AU - van Leeuwen, A. Elise
AU - Linn, Sabine
AU - de Munck, Linda
AU - Pijnappel, Ruud
AU - Strobbe, Luc
AU - van Dalen, Thijs
AU - Wesseling, Jelle
AU - Poortmans, Philip
N1 - Funding Information:
We thank all local PIs for carefully checking the RT details: W. Smit (Radiation Institute Friesland, Leeuwarden), M. van Hezewijk (Leiden University Medical Centre), M. Stenfert Kroese (RT-group Deventer), D. van de Bongard (Utrecht University Medical Centre), M. van der Sangen (Catharina Hospital, Eindhoven), M. Baaijens (Erasmus Medical Centre, Rotterdam), A. Jonkman (Medical Spectrum Twente, Enschede), D. Schinagl (Radboud University Medical Centre), M. Mast (Haga Hospital, The Hague), D. Rietveld (Free University Medical Centre, Amsterdam), J. Maduro (University Medical Centre Groningen), M. Stam (RT-group Arnhem), B. Wachters (Zeeland Radiotherapy Institute, Vlissingen), L. Zwanenburg (Isala Hospital, Zwolle), L. Scheijmans (Verbeeten Institute, Tilburg). Datamanagement was funded by the Dutch Cancer Society grant nr: 2010-4679.
Funding Information:
We thank all local PIs for carefully checking the RT details: W. Smit (Radiation Institute Friesland, Leeuwarden), M. van Hezewijk (Leiden University Medical Centre), M. Stenfert Kroese (RT-group Deventer), D. van de Bongard (Utrecht University Medical Centre), M. van der Sangen (Catharina Hospital, Eindhoven), M. Baaijens (Erasmus Medical Centre, Rotterdam), A. Jonkman (Medical Spectrum Twente, Enschede), D. Schinagl (Radboud University Medical Centre), M. Mast (Haga Hospital, The Hague), D. Rietveld (Free University Medical Centre, Amsterdam), J. Maduro (University Medical Centre Groningen), M. Stam (RT-group Arnhem), B. Wachters (Zeeland Radiotherapy Institute, Vlissingen), L. Zwanenburg (Isala Hospital, Zwolle), L. Scheijmans (Verbeeten Institute, Tilburg). Datamanagement was funded by the Dutch Cancer Society grant nr: 2010-4679 .
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/4
Y1 - 2020/4
N2 - We conducted a prospective cohort study in the Netherlands (RAPCHEM: NCT01279304, BOOG 2010-03) in breast cancer (BC) patients treated with primary systemic therapy (PST), followed by surgery and post-operative radiation therapy (RT) according to a predefined consensus-based study-guideline (SG). The aim of the current analysis is to evaluate adherence to the SG.From January 2011 to January 2015, patients with cT1-2N1 BC treated in 17 Dutch RT Centres were included. Patients with four or more suspicious nodes at imaging were excluded. SG recommended whole breast RT for patients treated with breast conserving therapy. SG on loco(-regional) RT were defined for three risk groups based on the ypN status: (1) ypN0 (low-risk): RT breast and no RT after mastectomy; (2) ypN1 (intermediate-risk): RT breast or chest wall; (3) ypN2 (high-risk): RT breast or chest wall, including regional lymph nodes.We included 848 patients: 292 in the low-risk group; 374 in the intermediate-risk group; 182 in the high-risk group. Overall, 64% of the patients was treated according to the SG; 11% received less RT than the predefined target volumes and 25% received more extensive RT than according to the SG. The largest variation was seen in the intermediate risk group, where only 54% was treated according to the SG.Substantial deviation from the SG for post-operative RT was observed after PST, especially in patients with an intermediate-risk. Future analyses will evaluate outcome of these patients in relation to risk factors and the actual RT given.Copyright © 2020 Elsevier B.V. All rights reserved.
AB - We conducted a prospective cohort study in the Netherlands (RAPCHEM: NCT01279304, BOOG 2010-03) in breast cancer (BC) patients treated with primary systemic therapy (PST), followed by surgery and post-operative radiation therapy (RT) according to a predefined consensus-based study-guideline (SG). The aim of the current analysis is to evaluate adherence to the SG.From January 2011 to January 2015, patients with cT1-2N1 BC treated in 17 Dutch RT Centres were included. Patients with four or more suspicious nodes at imaging were excluded. SG recommended whole breast RT for patients treated with breast conserving therapy. SG on loco(-regional) RT were defined for three risk groups based on the ypN status: (1) ypN0 (low-risk): RT breast and no RT after mastectomy; (2) ypN1 (intermediate-risk): RT breast or chest wall; (3) ypN2 (high-risk): RT breast or chest wall, including regional lymph nodes.We included 848 patients: 292 in the low-risk group; 374 in the intermediate-risk group; 182 in the high-risk group. Overall, 64% of the patients was treated according to the SG; 11% received less RT than the predefined target volumes and 25% received more extensive RT than according to the SG. The largest variation was seen in the intermediate risk group, where only 54% was treated according to the SG.Substantial deviation from the SG for post-operative RT was observed after PST, especially in patients with an intermediate-risk. Future analyses will evaluate outcome of these patients in relation to risk factors and the actual RT given.Copyright © 2020 Elsevier B.V. All rights reserved.
KW - SURGICAL ADJUVANT BREAST
KW - INDIVIDUAL PATIENT DATA
KW - NEOADJUVANT CHEMOTHERAPY
KW - PREOPERATIVE CHEMOTHERAPY
KW - LOCOREGIONAL RECURRENCE
KW - POSTMASTECTOMY RADIOTHERAPY
KW - AXILLARY DISSECTION
KW - INTERNAL MAMMARY
KW - CANCER PATIENTS
KW - MASTECTOMY
U2 - 10.1016/j.radonc.2020.01.018
DO - 10.1016/j.radonc.2020.01.018
M3 - Article
C2 - 32058873
SN - 0167-8140
VL - 145
SP - 201
EP - 208
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -