BACKGROUND: Optimal treatment for breast cancer often involves lengthy multimodality care including 5 to 6 weeks of radiotherapy, but few studies have evaluated adherence to radiotherapy outside the context of a therapeutic clinical trial. METHODS: Using a SEER-Medicare database, the authors identified women age 66 years or older with Stage I to III breast cancer diagnosed between 1992 and 2002. They evaluated rates of completion of radiotherapy, defined as a minimum of 25 sessions. Multivariate logistic regression analyses were performed to determine factors associated with completion of radiotherapy, and Cox multivariate models were used to determine the impact of radiotherapy completion on local recurrence. RESULTS: Some 24,510 patients were included in the study. Eighty-seven percent of patients completed 25 or more radiotherapy sessions. In multivariate logistic regression models, mastectomy (HR 1.26, 95% CI 1.10-1.43), hospitalization during treatment (2.87, 2.49-3.31), earlier year of diagnosis, and black race (1.36, 1.14-1.63) were associated with increased risk of non-completion of radiotherapy. Among 21,269 patients treated with breast conservation, incomplete radiotherapy was associated with higher risk of local recurrence. A total of 96.6% [corrected] of patients who did not complete radiation therapy were free of recurrence at 5 years vs. 97.5% of patients who completed radiation therapy (HR 1.46, CI 1.09-1.95). CONCLUSION: This study demonstrates relatively high rates of completion of radiation therapy among a population of older woman with breast cancer. However, those who did not complete a full course of radiotherapy had small but statistically significant higher risk of breast cancer recurrence. Future efforts should focus on intervening with women at high risk of not receiving adjuvant radiotherapy and increasing rates of radiotherapy completion. (Copyright) 2008 American Cancer Society.
BACKGROUND: Optimal treatment for breast cancer often involves lengthy multimodality care including 5 to 6 weeks of radiotherapy, but few studies have evaluated adherence to radiotherapy outside the context of a therapeutic clinical trial. METHODS: Using a SEER-Medicare database, the authors identified women age 66 years or older with Stage I to III breast cancer diagnosed between 1992 and 2002. They evaluated rates of completion of radiotherapy, defined as a minimum of 25 sessions. Multivariate logistic regression analyses were performed to determine factors associated with completion of radiotherapy, and Cox multivariate models were used to determine the impact of radiotherapy completion on local recurrence. RESULTS: Some 24,510 patients were included in the study. Eighty-seven percent of patients completed 25 or more radiotherapy sessions. In multivariate logistic regression models, mastectomy (HR 1.26, 95% CI 1.10-1.43), hospitalization during treatment (2.87, 2.49-3.31), earlier year of diagnosis, and black race (1.36, 1.14-1.63) were associated with increased risk of non-completion of radiotherapy. Among 21,269 patients treated with breast conservation, incomplete radiotherapy was associated with higher risk of local recurrence. A total of 96.6% [corrected] of patients who did not complete radiation therapy were free of recurrence at 5 years vs. 97.5% of patients who completed radiation therapy (HR 1.46, CI 1.09-1.95). CONCLUSION: This study demonstrates relatively high rates of completion of radiation therapy among a population of older woman with breast cancer. However, those who did not complete a full course of radiotherapy had small but statistically significant higher risk of breast cancer recurrence. Future efforts should focus on intervening with women at high risk of not receiving adjuvant radiotherapy and increasing rates of radiotherapy completion. (Copyright) 2008 American Cancer Society.
Authors: J S Mandelblatt; J Hadley; J F Kerner; K A Schulman; K Gold; J Dunmore-Griffith; S Edge; E Guadagnoli; J J Lynch; N J Meropol; J C Weeks; R Winn Journal: Cancer Date: 2000-08-01 Impact factor: 6.860
Authors: Ahmedin Jemal; Rebecca Siegel; Elizabeth Ward; Taylor Murray; Jiaquan Xu; Michael J Thun Journal: CA Cancer J Clin Date: 2007 Jan-Feb Impact factor: 508.702
Authors: Timothy Whelan; Robert MacKenzie; Jim Julian; Mark Levine; Wendy Shelley; Laval Grimard; Barbara Lada; Himu Lukka; Francisco Perera; Anthony Fyles; Ethan Laukkanen; Sunil Gulavita; Veronique Benk; Barbara Szechtman Journal: J Natl Cancer Inst Date: 2002-08-07 Impact factor: 13.506
Authors: B Fisher; C Redmond; E R Fisher; M Bauer; N Wolmark; D L Wickerham; M Deutsch; E Montague; R Margolese; R Foster Journal: N Engl J Med Date: 1985-03-14 Impact factor: 91.245
Authors: B Fisher; M Bauer; R Margolese; R Poisson; Y Pilch; C Redmond; E Fisher; N Wolmark; M Deutsch; E Montague Journal: N Engl J Med Date: 1985-03-14 Impact factor: 91.245
Authors: Yotam Arens; Michael Gaisa; Stephen E Goldstone; Yuxin Liu; Juan Wisnivesky; Carlie S Sigel; Talia H Swartz; Keith Sigel Journal: Dis Colon Rectum Date: 2019-08 Impact factor: 4.585
Authors: Carlos H Barcenas; Ning Zhang; Hui Zhao; Zhigang Duan; Thomas A Buchholz; Gabriel N Hortobagyi; Sharon H Giordano Journal: Oncologist Date: 2012-02-27
Authors: Shi-Yi Wang; Jessica B Long; Brigid K Killelea; Suzanne B Evans; Kenneth B Roberts; Andrea L Silber; Amy J Davidoff; Tannaz Sedghi; Cary P Gross Journal: Breast Cancer Res Treat Date: 2018-08-11 Impact factor: 4.872
Authors: Albert J Farias; Ryan N Hansen; Steven B Zeliadt; India J Ornelas; Christopher I Li; Beti Thompson Journal: Am J Clin Oncol Date: 2018-07 Impact factor: 2.339
Authors: Jennifer L Patnaik; Tim Byers; Carolyn Diguiseppi; Thomas D Denberg; Dana Dabelea Journal: J Natl Cancer Inst Date: 2011-06-30 Impact factor: 13.506