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

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

Strahlenther. Onkol. 196, 15–22 (2020)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
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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Publication type Article: Journal article
Document type Scientific Article
Keywords Lymph Node Irradiation ; Breast Cancer ; Variability ; Patterns Of Care ; Survey; Estro Consensus Guideline; Elective Radiation-therapy; Target Volume Delineation; Internal Mammary; Radiotherapy
Language english
Publication Year 2020
Prepublished in Year 2019
HGF-reported in Year 2019
ISSN (print) / ISBN 0179-7158
e-ISSN 1439-099X
Journal Strahlentherapie und Onkologie : Journal of Radiation Oncology, Biology, Physics
Quellenangaben Volume: 196, Issue: 1, Pages: 15–22 Article Number: , Supplement: ,
Publisher Urban & Vogel
Publishing Place Tiergartenstrasse 17, D-69121 Heidelberg, Germany
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)
POF-Topic(s) 30203 - Molecular Targets and Therapies
Research field(s) Radiation Sciences
PSP Element(s) G-501300-001
DOI 10.1007/s00066-019-01537-3
WOS ID WOS:000496407800002
Scopus ID 85075191713
PubMed ID 31722060
Erfassungsdatum 2019-11-25
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