Radiation practice patterns among United States radiation oncologists for postmastectomy breast reconstruction and oncoplastic breast reduction
| Autor: | Kimberly Thomas, A.S. Rahimi, Ann Spangler, J.F. Anderson, Dan Garwood |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Mammaplasty Breast Neoplasms Medical Oncology Surveys and Questionnaires medicine Humans Radiology Nuclear Medicine and imaging Practice Patterns Physicians' Radiation oncologist Mastectomy Radiotherapy business.industry Lumpectomy United States Surgery Radiation therapy Oncology Radiation Oncology Female Breast reduction business Breast reconstruction Bolus (radiation therapy) |
| Zdroj: | Practical radiation oncology. 4(6) |
| ISSN: | 1879-8519 |
| Popis: | Background For patients requiring radiation therapy following mastectomy or breast reconstruction, there often exist much heterogeneity among practitioners with respect to radiation technique. Methods and materials A 14-question survey was sent nationwide to 1000 active email addresses from the American Society for Radiation Oncology member directory; 271 radiation oncologists completed the survey. Results A total of 75.2% of respondents indicate that they do not routinely deflate the ipsilateral tissue expander (TE) prior to radiation, while 11.5% do routinely deflate ( P ≤ .01); 52.2% indicate that they typically use bolus when treating their patients with TEs following mastectomy, 36.7% do not, and 11.1% on a case by case basis ( P ≤ .01). Of respondents indicating bolus utilization, 32.8% use a bolus of 0.5 cm every other day; 31.4% indicate a bolus of 0.5 cm every day until tolerated; 20.4% use a bolus of 1 cm every other day; 5.8% indicate a bolus of 1 cm every day until tolerated; and 9.5% indicate a customized bolus approach ( P ≤ .01). A total of 22.9% of respondents deliver boost to all patients with TE while 42.9% deliver boost only to select patients, and 33.5% indicate no utilization of boost ( P ≤ .01). A total of 33.1% indicate that collaborating surgeons routinely place clips at the lumpectomy cavity at the time of breast reduction or complex tissue rearrangement, while 38.3% indicate that clips are occasionally placed, and 28.6% stated clips are not routinely placed ( P = .15); 38.7% of respondents routinely deliver a boost for patients undergoing breast reduction only if clips have been placed in the tumor cavity, while 34.6% indicate that a boost is used regardless of clip placement. Conclusions Radiation treatments with tissue expanders have become common practice, but details of radiation treatment vary widely. Radiation oncologist and breast surgeons should continue to work to optimize radiation techniques and allow proper localization for radiation boost. |
| Databáze: | OpenAIRE |
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