Comparing Radiation Treatment for Breast Cancer in Canada and the U.S.
Author Information
Author(s): Ian Dayes, T.J. Whelan, Julian J. A., M.R. Kuettel, D. Regmi, G.S. Okawara, M. Patel, H.I. Reiter, S. Dubois
Primary Institution: Juravinski Cancer Centre, McMaster University
Hypothesis
How do radiation fractionation patterns differ between Canadian and U.S. treatment centers for early breast cancer?
Conclusion
The study found significant differences in radiation treatment practices between U.S. and Canadian centers, particularly in the total dose and number of fractions prescribed.
Supporting Evidence
- U.S. patients received a median total dose of 6040 cGy compared to 4250 cGy for Canadian patients.
- Boost irradiation was given to 97% of U.S. patients but only 9% of Canadian patients.
- Seven different schedules for whole-breast irradiation were used in the U.S. compared to two in Canada.
Takeaway
Doctors in the U.S. and Canada treat breast cancer differently, with U.S. patients often getting more radiation over more sessions than Canadian patients.
Methodology
A retrospective review comparing radiation prescribed to patients following breast-conserving surgery for invasive breast cancer, with a matched sample from a Canadian center.
Potential Biases
Potential influence of the referral program on treatment practices.
Limitations
The study's retrospective nature and limited generalizability due to being based on only three centers.
Participant Demographics
Mean patient age was 60.7 years; patients were matched on age, nodal status, T stage, grade, and estrogen receptor status.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.001
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