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01-01-2020 | Breast Cancer | Original Article

Variability in lymph node irradiation in patients with breast cancer—results from a multi-center survey in German-speaking countries

Authors: K. J. Borm, MD, K. Kessel, M. Devecka, S. Muench, C. Straube, K. Schiller, L. Schüttrumpf, H. Dapper, B. Wöller, S. Pigorsch, S. E. Combs

Published in: Strahlentherapie und Onkologie | Issue 1/2020

Abstract

Purpose

Lymph node irradiation in breast cancer has gained complexity due to recently published studies and technical innovations which then led to changes in international guidelines. We sought to determine real-time variability in lymph node irradiation in clinical practice in German-speaking countries.

Methods

The Department of Radiation Oncology, Technical University of Munich (TUM), developed an online-based questionnaire focusing on the indication, target definition, and treatment technique of lymph node irradiation in patients with breast cancer. The invitation to participate in the survey was sent to members of the German Society of Radiation Oncology (DEGRO) by e‑mail. The results of the survey were exported from the online platform into SPSS for a detailed analysis.

Results

In total, 100 physicians completed the questionnaire between 05/2019 and 06/2019. Despite the existence of several treatment and contouring guidelines, we observed large variability of lymph node irradiation: The guideline recommendation for internal mammary irradiation is not consistently implemented in clinical practice and irradiation of the axilla after positive SLNB (sentinel lymph node biopsy) or ALND (axillary lymph node dissection) is handled very differently. Furthermore, in most clinics, the ESTRO (European Society for Therapeutic Radiology and Oncology) contouring consensus is not used, and PTV (planning target volume) definitions and margins vary considerably.

Conclusion

Further clinical studies should be performed with a particular focus on radiotherapy for lymphatic drainage to support and amend the existing guidelines. These studies should establish a more standardized treatment of the lymph node regions in clinical practice. Quality assurance should enforce broad implementation of consensus recommendations.

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Title: Variability in lymph node irradiation in patients with breast cancer—results from a multi-center survey in German-speaking countries
Authors: K. J. Borm, MD
K. Kessel
M. Devecka
S. Muench
C. Straube
K. Schiller
L. Schüttrumpf
H. Dapper
B. Wöller
S. Pigorsch
S. E. Combs
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 1/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01537-3

At a glance: The STEP trials

Springer Medicine

Variability in lymph node irradiation in patients with breast cancer—results from a multi-center survey in German-speaking countries

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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