TY - JOUR
T1 - Patterns of care study in Japan
T2 - Analysis of patients subjected to mastectomy followed by radiotherapy
AU - Shikama, Naoto
AU - Sasaki, Shigeru
AU - Mitsumori, Michihide
AU - Hiraoka, Masahiro
AU - Yamauchi, Chikako
AU - Yamamoto, Tokihiro
AU - Teshima, Teruki
AU - Inoue, Toshihiko
PY - 2003/9/1
Y1 - 2003/9/1
N2 - Background: Two prospective studies reported in 1997 demonstrated that postoperative radiotherapy after mastectomy was not only associated with a higher loco-regional control rate but also with a higher overall survival rate. The purpose of this study is to clarify the processes of care for patients undergoing mastectomy and postoperative radiotherapy in Japan. Methods: A national survey carried out in 1998-2000, involving 79 Japanese institutions by two-stage cluster sampling of institutions and patients, disclosed that 1124 patients with breast cancer had been treated between 1995 and 1997. Mastectomy followed by radiotherapy was performed on 258 patients. Results: The compliance rates for pre-treatment evaluation, including history, physical examination and mammography, averaged ∼50% (24-81%). The chest wall was irradiated in only 19% of the patients and regional node irradiation was carried out for 70-86%. Radiation treatment planning with the aid of computed tomography was done in only 29% of patients (university hospitals or cancer centers, 39%; other hospitals, 17%; P = 0.001). Hormonal therapy was administered to 56% of the patients who showed no endocrine responsiveness. Non-intensive chemotherapy, which did not include the use of anthracycline or taxol, was used in 55% of the patients who received chemotherapy. Conclusions: There is room for improvement regarding some aspects of radiotherapy and adjuvant systemic therapies. Especially in the field of radiotherapy, significant differences were found among the treatment techniques employed in various institutions.
AB - Background: Two prospective studies reported in 1997 demonstrated that postoperative radiotherapy after mastectomy was not only associated with a higher loco-regional control rate but also with a higher overall survival rate. The purpose of this study is to clarify the processes of care for patients undergoing mastectomy and postoperative radiotherapy in Japan. Methods: A national survey carried out in 1998-2000, involving 79 Japanese institutions by two-stage cluster sampling of institutions and patients, disclosed that 1124 patients with breast cancer had been treated between 1995 and 1997. Mastectomy followed by radiotherapy was performed on 258 patients. Results: The compliance rates for pre-treatment evaluation, including history, physical examination and mammography, averaged ∼50% (24-81%). The chest wall was irradiated in only 19% of the patients and regional node irradiation was carried out for 70-86%. Radiation treatment planning with the aid of computed tomography was done in only 29% of patients (university hospitals or cancer centers, 39%; other hospitals, 17%; P = 0.001). Hormonal therapy was administered to 56% of the patients who showed no endocrine responsiveness. Non-intensive chemotherapy, which did not include the use of anthracycline or taxol, was used in 55% of the patients who received chemotherapy. Conclusions: There is room for improvement regarding some aspects of radiotherapy and adjuvant systemic therapies. Especially in the field of radiotherapy, significant differences were found among the treatment techniques employed in various institutions.
KW - Breast cancer
KW - Mastectomy
KW - Patterns of care study
KW - Radiotherapy
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U2 - 10.1093/jjco/hyg085
DO - 10.1093/jjco/hyg085
M3 - Article
C2 - 14594939
AN - SCOPUS:0642372043
VL - 33
SP - 456
EP - 462
JO - Japanese Journal of Clinical Oncology
JF - Japanese Journal of Clinical Oncology
SN - 0368-2811
IS - 9
ER -