Ultrahypofractionated Adjuvant Breast Radiation Therapy (± Boost) and Virtual Consultations: Patient Perspectives at 1 Year

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-11-05 DOI:10.1016/j.adro.2024.101668

Jill Theresa Nicholson MBBS, BSc, MRCP, FFFRRCSI , Sinead Cleary MB Bch BAO, BA, MRCPI , Gemma Farmer MB Bch BAO, BA, MRCPI , Orla Monaghan MB Bch BAO, BA, MRCPI , Hannah O’ Driscoll MB Bch BAO, BA, MRCPI , Killian Nugent MB Bch BAO, BA, MRCPI, FFRRCSI , Bahareh Khosravi BSc , Eaine Quinlan MB Bch BAO, BA, MRCPI , Orla McArdle MB Bch BAO, BA, MRCPI, FFRRCSI, MSc , Fran K. Duane MB Bch BAO, BA, MRCPI, FFRRCSI, DPhil

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引用次数: 0

Abstract

Purpose

In March 2020, a 1-week ultrahypofractionated adjuvant breast radiation therapy schedule, 26 Gy in 5 fractions, and telehealth were adopted to reduce the risk of COVID-19 for staff and patients. This study describes real-world 1-year late toxicity for ultrahypofractionation (including a sequential boost) and patient perspectives on this new schedule and telehealth workflows.

Methods and Materials

Consecutive patients were enrolled between March and August 2020. Patient-reported outcome measures, including the presence of breast pain, swelling, firmness, and others, were recorded using the European Organisation for research and treatment of cancer quality of life questionairre (EORTC QLQ) BR45 at baseline, 3 months, 6 months, and 1 year. Virtual teleconferencing without video was used. Patients were invited to use video at 1 year for a physician-based assessment, including breast inspection. Patient-reported experience measures were also collected at 1 year to capture how a shortened schedule and telehealth influenced patient experience.

Results

In total, 121 of 135 patients completed at least 2 assessments, of which 33 (25%) received a sequential boost. The majority of patients reported no toxicity or mild toxicity at all 3 time points: 76% at 3 months, 76% at 6 months, and 82% at 1 year. When comparing 26 Gy in 5 fractions alone versus 26 Gy in 5 fractions followed by a sequential boost, there was no difference in toxicity reported at 1 year. A total of 94% felt supported by the medical team throughout their treatment course using telehealth-only consultations. Only 27% actually agreed to video consultation for the purpose of breast inspection when offered.

Conclusions

Ultrahypofractionated breast radiation therapy leads to acceptable late toxicity at 1 year, even when followed by a hypofractionated tumor bed boost. Patient satisfaction with ultrahypofractionated treatment and virtual consultations without video was high. Further investigation concerning the patient's acceptance of video consultations for a physician-based assessment, including breast inspection, is warranted.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.