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Outcome of differen...
Outcome of different radiotherapy strategies after breast conserving surgery in patients with ductal carcinoma in situ (DCIS)
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- Wärnberg, Fredrik (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Wadsten, Charlotta (författare)
- Umeå universitet,Kirurgi,Umeå Univ, Sundsvall Hosp, Dept Surg, Umeå, Sweden.
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- Karakatsanis, Andreas (författare)
- Uppsala universitet,Endokrinkirurgi,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- Olofsson Bagge, Roger, 1978 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Holmberg, Erik, 1951 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology
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- Lindman, Henrik (författare)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi,Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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- Sawyer, Elinor (författare)
- Kings Coll London, Guys Canc Ctr, London, England.,Guys Cancer centre, Kings College London, London, United Kingdom
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- Vicini, Frank (författare)
- NRG, Reg Oncol Ctr, Oncol, Pontiac, MI USA.;21st Century Oncol, Pontiac, MI USA.,Regional Oncologic Centre, NRG, Oncology, and 21st Century Oncology, MI, Pontiac, United States
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- Mann, G. Bruce (författare)
- Univ Melbourne, Dept Surg, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia
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- Karlsson, Per, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology
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(creator_code:org_t)
- Taylor & Francis, 2023
- 2023
- Engelska.
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 62:9, s. 1045-1051
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- Background: Adjuvant radiotherapy (RT) after breast-conserving surgery for DCIS lowers the relative local recurrence risk by half. To identify a low-risk group with the minimal benefit of RT could avoid side effects and spare costs. In this study, the outcome was compared for different RT-strategies using data from the randomized SweDCIS trial.Material and methods: Five strategies were compared in a Swedish setting: RT-to-none or all, RT to high-risk women defined by DCISionRT, modified Radiation Therapy Oncology Group (RTOG) 9804 criteria, and Swedish Guidelines. Ten-year recurrence risks and cost including adjuvant RT and local recurrence treatment cost were calculated.Results: The mean age at recurrence was 64.4 years (36-90) and the mean cost for treating a recurrence was $21,104. In the SweDCIS cohort (n = 504), 59 women developed DCIS, and 31 invasive recurrence. Ten-year absolute local recurrence risk (invasive and DCIS) according to different strategies varied between 18.6% (12.5-23.6%) and 7.8% (5.0-12.6%) for RT-to-none or to-all, with an additional cost of $2614 US dollars per women and $24,201 per prevented recurrence for RT-to-all. The risk differences between other strategies were not statistically significant, but the larger proportion receiving RT, the fewer recurrences. DCISionRT spared 48% from RT with 8.1% less recurrences compared to RT-to-none, and a cost of $10,534 per prevented recurrence with additional cost depending on the price of the test. RTOG 9804 spared 39% from RT, with 9.7% less recurrences, $9525 per prevented recurrence and Swedish Guidelines spared 13% from RT, with 10.0% less recurrences, and $21,521 per prevented recurrence.Conclusion: It seems reasonable to omit RT in pre-specified low-risk groups with minimal effect on recurrence risk. Costs per prevented recurrence varied more than two-fold but which strategy that could be considered most cost-effective needs to be further evaluated, including the DCISionRT-test price.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- DCIS
- radiotherapy
- recurrence
- outcome
- cost
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- ref (ämneskategori)
- art (ämneskategori)
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Wärnberg, Fredri ...
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Wadsten, Charlot ...
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Karakatsanis, An ...
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Olofsson Bagge, ...
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Holmberg, Erik, ...
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Lindman, Henrik
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Sawyer, Elinor
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Vicini, Frank
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Mann, G. Bruce
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Karlsson, Per, 1 ...
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