Minimizing toxicity in breast irradiation

Shah, Chirag; Banda, Bhanu; Chandra, Rohit; Vicini, Frank A.

doi:10.1080/14737140.2017.1285231

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…Our findings reveal that 78.6 % and 81.3 % of patients treated with Co-60 teletherapy and 6 MV linac machines, respectively, reported experiencing fatigue at the conclusion of their treatments. This aligns with the established literature, where Shah et al [ 27 ] affirm fatigue as the second most predominant radiation toxicity encountered by patients undergoing radiation therapy.…”

Section: Discussionsupporting

confidence: 90%

“…Within the domain of acute radiation toxicity, radiation dermatitis emerges as a predominant concern in breast cancer radiotherapy, corroborating established findings in the literature. Shah et al [ 27 ], Yee et al [ 28 ], and Fisher et al [ 29 ] have collectively underscored the prevalence of radiation dermatitis, afflicting 90.0 % of breast cancer patients undergoing radiotherapy, with 30.0 % exhibiting moderate to severe symptoms. This study resonates with these observations, revealing a 100.0 % incidence of radiation dermatitis upon the completion of treatment for both Co-60 teletherapy and 6 MV linac machines.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and severity of acute radiation induced toxicities among breast cancer patients treated with adjuvant radiotherapy at a major cancer treatment center in Ghana

Kyei,

Daniels,

Pratt-Ainooson

et al. 2024

Translational Oncology

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Incidence and severity of acute radiation induced toxicities among breast cancer patients treated with adjuvant radiotherapy at a major cancer treatment center in Ghana

Kyei,

Daniels,

Pratt-Ainooson

et al. 2024

Translational Oncology

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“…[5, 6] Long-term cardiac morbidity is an established late effect of radiation therapy for breast cancer which may have a significant impact on quality of life. [7–10] IMRT also allows for more homogenous dose distribution, avoiding areas of high radiation dose. Canadian and European trials have demonstrated decreased skin toxicity and better cosmetic outcomes with better dose homogeneity.…”

Section: Introductionmentioning

confidence: 99%

Intensity modulated radiation therapy following lumpectomy in early-stage breast cancer: Patterns of use and cost consequences among Medicare beneficiaries

et al. 2019

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PurposeIn 2013, the American Society for Radiation Oncology (ASTRO) issued a Choosing Wisely recommendation against the routine use of intensity modulated radiotherapy (IMRT) for whole breast irradiation. We evaluated IMRT use and subsequent impact on Medicare expenditure in the period immediately preceding this recommendation to provide a baseline measure of IMRT use and associated cost consequences.Methods and materialsSEER records for women ≥66 years with first primary diagnosis of Stage I/II breast cancer (2008–2011) were linked with Medicare claims (2007–2012). Eligibility criteria included lumpectomy within 6 months of diagnosis and radiotherapy within 6 months of lumpectomy. We evaluated IMRT versus conventional radiotherapy (cRT) use overall and by SEER registry (12 sites). We used generalized estimating equations logit models to explore adjusted odds ratios (OR) for associations between clinical, sociodemographic, and health services characteristics and IMRT use. Mean costs were calculated from Medicare allowable costs in the year after diagnosis.ResultsAmong 13,037 women, mean age was 74.4, 50.5% had left-sided breast cancer, and 19.8% received IMRT. IMRT use varied from 0% to 52% across SEER registries. In multivariable analysis, left-sided breast cancer (OR 1.75), living in a big metropolitan area (OR 2.39), living in a census tract with ≤$90,000 median income (OR 1.75), neutral or favorable local coverage determination (OR 3.86, 1.72, respectively), and free-standing treatment facility (OR 3.49) were associated with receipt of IMRT (p<0.001). Mean expenditure in the year after diagnosis was $8,499 greater (p<0.001) among women receiving IMRT versus cRT.ConclusionWe found highly variable use of IMRT and higher expenditure in the year after diagnosis among women treated with IMRT (vs. cRT) with early-stage breast cancer and Medicare insurance. Our findings suggest a considerable opportunity to reduce treatment variation and cost of care while improving alignment between practice and clinical guidelines.

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