Purpose: Whole breast irradiation after conservative surgery is the standard treatment for invasive breast cancer. Randomized studies indicate that hypofractionation can be equivalent for selected patients. This study focuses on fractionation practice evolution in a single centre, and analyses the economic impact of practice modification.
Material And Methods: All prescriptions for invasive breast cancer between January 2010 and June 2014 were analyzed. Female patients 60 years or older, pN0 were considered for the economic study. Patients included in clinical trials or patient with high-grade tumours were excluded from the hypofractionation practice study, because physician could not choose fractionation. We used data from the Medical public health system to calculate cost per fraction and transportation cost.
Results: Two thousand thirty one patients were treated; 399 were eligible for the economic study (20%) and 282 for the practice study (14%). Treatment with 25 fractions decreased from 90% to 16% in the first half of 2014. Meanwhile, treatment with 15 or 16 fractions increased from 6% in 2010 to 68% in the first half of 2014. Hypofractionated treatment proportion was 100% with 42.5Gy in 16 fractions in 2010 and 100% 40Gy in 15 fractions in 2014, according to long-term follow-up publication of START trials. Treatment with five fractions remained stable around 7% (4 to 16%), reserved for patients over 80 years (P<0.0001). Based on data from 3451 fractions in 2013, transport cost was calculated at 62 € per fraction, in addition to a 170.77 € reimbursement per fraction, giving a cost per fraction of 232.77 €.
Conclusion: Practice change led to an increase of hypofractionation in recent years. Hypofractionation may be currently prescribed and may concern 20% of patients. This practice evolution is beneficial for patients and the public health system.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.canrad.2016.04.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence.
JNCI Cancer Spectr
January 2025
Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
Background: Obesity, classified by body mass index (BMI), is associated with higher postmenopausal breast cancer (BCa) risk. Yet, the associations between abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) with BCa are unclear.
Methods: We assessed BCa associations with abdominal VAT and SAT in a prospective cohort of postmenopausal women without a history of cancer and with 27 years follow-up (N = 9950), during which all new cancers were adjudicated.
Comparison of Short-term Outcomes Following Minimally Invasive (Endoscopic/Robotic) vs Open Thyroidectomy for Patients With Thyroid Cancer.
Eur Thyroid J
January 2025
L Chen, Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, 400038, China.
Background Selection between open thyroidectomy (OT) and minimally invasive (endoscopic/robotic) thyroidectomy (MT) for patients with thyroid cancer has been a subject of considerable debate. Comprehensive analysis of the short-term outcomes of endoscopic thyroidectomy (ET), robotic thyroidectomy (RT) and OT for thyroid cancer using a large-scale dataset is important. Methods This cohort study evaluated the outcomes of patients receiving ET, RT vs OT for thyroid cancer from January 1, 2003, to December 31, 2022.
View Article and Find Full Text PDFA Self-Amplifying Photodynamic Biomedicine for Cascade Immune Activation Against Triple-Negative Breast Cancer.
Small
January 2025
Fujian Provincial Key Laboratory of Transplant Biology, Laboratory of Basic Medicine, Fuzong Clinical College of Fujian Medical University (900th Hospital of the Joint Logistics Support Force), Fuzhou, 350025, China.
The efficacy of immunotherapy in triple-negative breast cancer (TNBC) is significantly hindered by its low immunogenicity and immunosuppressive tumor microenvironment. Non-invasive photodynamic therapy (PDT) is increasingly recognized as a potential immunotherapeutic stimulant in the treatment of TNBC. However, photodynamic immunotherapy is constrained by tumor hypoxia and excessive inflammation suppression during the course of treatment.
View Article and Find Full Text PDFReceptor discordance after nipple-sparing mastectomy.
Surg Pract Sci
June 2024
Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Background: Recent studies have shown that receptor status of breast cancer change between primary tumor and recurrence, which may influence treatment strategy and prognosis, but there are few reports on receptor discordance between primary tumors and local recurrence (LR) after nipple-sparing mastectomy (NSM).
Patients And Methods: We collected 74 patients who had LR after NSM for newly diagnosed stages 0 to 3 breast cancer between 2008 and 2016 at 14 institutions. We classified into 4 subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2).
Targeting heparan sulfate proteoglycans as an effective strategy for inhibiting cancer cell migration and invasiveness compared to heparin.
Front Cell Dev Biol
January 2025
Department of Medical Biotechnologies, University of Siena, Siena, Italy.
By virtue of their ability to bind different growth factors, morphogens and extracellular matrix proteins, heparan sulfate proteoglycans (HSPGs) play a determinant role in cancer cell differentiation and migration. Despite a strong conceptual basis and promising preclinical results, clinical trials have failed to demonstrate any significant advantage of administering heparin to oncology patients. We exploited our anti-heparan sulfate branched peptide NT4 to test the opposite approach, namely, targeting HSPGs to interfere with their functions, instead of using heparin as a soluble competitor in human cell lines from pancreas adenocarcinoma, colon adenocarcinoma, rhabdomyosarcoma and two different breast cancers.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!