Impact of COVID-19 Pandemic on Completion of Radiation Therapy After Lumpectomy for Early-Stage Breast Cancer

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2026-04-01 Epub Date: 2026-02-26 DOI:10.1016/j.clbc.2026.02.004

Alexandra Stump , Marie Gordon , Evan Becker , Kai Ding , Shearwood McClelland III

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引用次数: 0

Abstract

Background

Whole-breast radiation therapy (RT) following lumpectomy has become a standard of care for early-stage breast cancer (ESBC) treatment. Hypofractionated RT (HFRT) has demonstrated equivalent oncologic efficacy to standard fractionation (SFRT). The COVID-19 pandemic accelerated adoption of shorter treatment regimens; however, its impact on RT completion rates and treatment equity has not been well-characterized.

Methods

Using the National Cancer Database, patients with ESBC who received post-lumpectomy RT from 2018 to 2022 were identified. SFRT was defined as 1.8-2.0 Gy per fraction and HFRT as 2.66-2.70 Gy per fraction. RT completion was defined as receipt of ≥ 46 Gy for SFRT and ≥ 40 Gy for HFRT. Pre-COVID (2018-2019) and post-COVID (2021-2022) RT completion and HFRT adoption rates were compared using chi-square tests. Adoption and completion were analyzed by race, ethnicity, income, and facility type.

Results

Among 25,658 patients (pre-COVID n = 13,381; post-COVID n = 12,277), HFRT use increased from 82.9% to 93.6%, while SFRT declined from 17.1% to 6.4% (P < .0001). Overall RT completion improved from 94.8% to 96.4% (P < .0001). HFRT completion rates remained higher than SFRT (pre-COVID: 97.2% HFRT vs. 83.1% SFRT; post-COVID: 97.5% vs. 80.5%). HFRT adoption increased across all racial and income groups (all P < .0001), with completion exceeding 96% across all subgroups. Racial and income disparities in HFRT differences decreased by a relative reduction of 53.3% and 40.5%, respectively.

Conclusions

Post-COVID shifts toward HFRT were associated with higher RT completion and reduced disparities, suggesting more efficient and equitable treatment delivery of adjuvant breast RT.

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COVID-19大流行对早期乳腺癌乳房肿瘤切除术后放疗完成的影响

背景：乳房肿瘤切除术后的全乳放射治疗（RT）已成为早期乳腺癌（ESBC）治疗的标准护理。低分割放射治疗（HFRT）已被证明与标准分割放射治疗（SFRT）具有相同的肿瘤疗效。COVID-19大流行加速了较短治疗方案的采用；然而，其对RT完成率和治疗公平性的影响尚未得到很好的表征。方法：使用国家癌症数据库，确定2018年至2022年接受乳房肿瘤切除术后RT治疗的ESBC患者。SFRT定义为1.8-2.0 Gy /馏分，HFRT定义为2.66-2.70 Gy /馏分。放疗完成定义为接受≥46 Gy的SFRT和≥40 Gy的HFRT。采用卡方检验比较covid前（2018-2019）和covid后（2021-2022）RT完成率和HFRT采用率。采用和完成情况按种族、民族、收入和设施类型进行分析。结果：25,658例患者（covid前n = 13,381； covid后n = 12,277）中，HFRT使用率从82.9%上升至93.6%，而SFRT使用率从17.1%下降至6.4% （P < 0.001）。总体RT完成率从94.8%提高到96.4% （P < 0.0001）。HFRT完成率仍然高于SFRT（新冠肺炎前：97.2% vs. 83.1%；新冠肺炎后：97.5% vs. 80.5%）。HFRT的采用率在所有种族和收入群体中都有所增加（均P < 0.0001），所有亚群体的完成率都超过96%。种族和收入差异在HFRT差异上的相对降幅分别为53.3%和40.5%。结论：covid后转向HFRT与更高的RT完成率和更小的差异相关，表明辅助乳腺RT治疗更有效和公平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.