Change in the Use of Fractionation in Radiotherapy Used for Early Breast Cancer at the Start of the COVID-19 Pandemic: A Population-Based Cohort Study of Older Women in England and Wales
- Resource Type
- Authors
- Melissa Gannon; David Dodwell; Katie Miller; Kieran Horgan; Karen Clements; Jibby Medina; Ian Kunkler; David Cromwell
- Source
- Gannon, M R, Dodwell, D, Miller, K, Horgan, K, Clements, K, Medina, J, Kunkler, I & Cromwell, D A 2022, ' Change in the Use of Fractionation in Radiotherapy Used for Early Breast Cancer at the Start of the COVID-19 Pandemic: A Population-Based Cohort Study of Older Women in England and Wales ', Clinical Oncology . https://doi.org/10.1016/j.clon.2022.05.019
- Subject
- Wales
COVID-19
Breast Neoplasms
General Medicine
Mastectomy, Segmental
Cohort Studies
Oncology
Humans
Surgery
Radiology, Nuclear Medicine and imaging
Female
Radiotherapy, Adjuvant
Pandemics
Mastectomy
Aged
- Language
- English
- ISSN
- 0936-6555
AIMS: Adjuvant radiotherapy is recommended for most patients with early breast cancer (EBC) receiving breast-conserving surgery and those at moderate/high risk of recurrence treated by mastectomy. During the first wave of COVID-19 in England and Wales, there was rapid dissemination of randomised controlled trial-based evidence showing non-inferiority for five-fraction ultra-hypofractionated radiotherapy (HFRT) regimens compared with standard moderate-HFRT, with guidance recommending the use of five-fraction HFRT for eligible patients. We evaluated the uptake of this recommendation in clinical practice as part of the National Audit of Breast Cancer in Older Patients (NABCOP). MATERIALS AND METHODS: Women aged ≥50 years who underwent surgery for EBC from January 2019 to July 2020 were identified from the Rapid Cancer Registration Dataset for England and from Wales Cancer Network data. Radiotherapy details were from linked national Radiotherapy Datasets. Multivariate mixed-effects logistic regression models were used to assess characteristics influential in the use of ultra-HFRT. RESULTS: Among 35 561 women having surgery for EBC, 71% received postoperative radiotherapy. Receipt of 26 Gy in five fractions (26Gy5F) increased from