Improvement in postmastectomy radiotherapy for breast cancer in mainland China:comparison of survey in 2010 with 2004 / 中华放射肿瘤学杂志

ABSTRACT

ObjectiveTo assess the current practice of postmastectomy radiotherapy (PMRT) in mainland China and to evaluate the improvement in the past six years.MethodsA questionnaire on the indications and techniques for PMRT for breast cancer was delivered to all radiotherapy centers of mainland China in 2010 survey,and the results were analyzed and compared with those in 2004 survey.The Fisher's exact test was used.ResultsCompared to 29.4％ (210/275) in 2004,396 of the 952 (41.6％) surveyed centers had performed PMRT.The median interval between surgery and PMRT was increased from 6 weeks to 12 weeks during the past 6 years.Adjuvant chemotherapy followed by PMRT was the most common combination in 73.5％ of the responding centers in 2010 other than Sandwich (71.7％) sequence of chemotherapy and PMRT in 2004.PMRT was only performed for T3 or Stage Ⅲ tumors and/or ≥ 4 positive lymph nodes (LN + ) in 7.1％ centers in 2004 and in 29.5％ centers in 2010 surveys,respectively.The use of PMRT for T1-2 N0 breast cancer,T1-2 N0 with tumors located in the center or inner quadrant,and stage T1-T2 and one to three LN + was decreased from 11.9％,63.8％,and 87.6％ in 2004 to 1.5％,19.7％,and 62.1％ in 2010,respectively (all P =0.000).The chest wall and the supraclavicular region were the most common radiation targets,which were used in 97.0％ and 97.0％ in 2010,similar to 97.1％and 96.2％ in 2004.Irradiation to the inner mammary area and axillary fossa decreased from 85.2％ and 74.8％ in 2004 to 39.1％ and 50.5％ in 2010.The boost to the chest wall was more based on the scar,increasingfrom9.0％ in004to75.0％ in 2010.Conclusions There are a high level of compliance of the practices with current guideline and continuing improvement of PMRT for breast cancer in mainland China.But it needs further improvement.