Fabiana Gregucci1, Alessandra Fozza2, Sara Falivene3, Daniela Smaniotto4, Anna Morra5, Antonino Daidone6, Raffaele Barbara7, Antonella Ciabattoni8. 1. Radiation Oncology Department, "F. Miulli" General Regional Hospital, Strada Prov 127, 70021, Acquaviva delle Fonti, Bari, Italy. fabianagregucci@gmail.com. 2. SC di Radioterapia, ASO S.S. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 3. UOC Radioterapia Oncologica, Ospedale del Mare, ASL 1 Napoli Centro, Naples, Italy. 4. Policlinico Universitario A. Gemelli IRCCS, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy. 5. Divisione di Radioterapia, IEO, Istituto Europeo di Oncologia, IRCCS, Milan, Italy. 6. UOC Radioterapia Oncologica, P.O. Abele Ajello, Mazara del Vallo, Italy. 7. UOC Radioterapia Oncologica, AO San Giovanni Addolorata, Rome, Italy. 8. UOC Radioterapia Oncologica, Ospedale San Filippo Neri, ASL Roma 1, Rome, Italy.
Abstract
AIMS: To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT). METHODS: A nationwide, 21-point questionnaire was distributed online via SurveyMonkey. RESULTS: Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BC patients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery. CONCLUSIONS: This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.
AIMS: To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT). METHODS: A nationwide, 21-point questionnaire was distributed online via SurveyMonkey. RESULTS: Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BCpatients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery. CONCLUSIONS: This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.
Entities:
Keywords:
AIRO; Breast cancer; Hypofractionated radiotherapy; Partial-breast irradiation; Radiotherapy and neoadjuvant therapy; Re-irradiation; Survey