Fax: (011) 6129828 5299
Estimation of an optimal radiotherapy utilization rate for breast carcinoma
A review of the evidence
Article first published online: 24 SEP 2003
Copyright © 2003 American Cancer Society
Volume 98, Issue 9, pages 1977–1986, 1 November 2003
How to Cite
Delaney, G., Barton, M. and Jacob, S. (2003), Estimation of an optimal radiotherapy utilization rate for breast carcinoma. Cancer, 98: 1977–1986. doi: 10.1002/cncr.11740
- Issue published online: 22 OCT 2003
- Article first published online: 24 SEP 2003
- Manuscript Revised: 31 JUL 2003
- Manuscript Accepted: 31 JUL 2003
- Manuscript Received: 10 APR 2003
- Australian Federal Department of Health and Aging
- breast carcinoma incidence;
- epidemiologic data;
- optimal radiotherapy use;
- sensitivity analysis
Radiotherapy utilization rates for breast carcinoma vary widely, both within and between countries. Current estimates of the proportion of patients with carcinoma who optimally should receive radiotherapy are based either on expert opinion or on the measurement of actual utilization rates, and not on the best scientific evidence.
To develop an evidence-based benchmark for radiotherapy utilization in patients with breast carcinoma, the authors undertook a systematic review of treatment guidelines on the use of radiotherapy for breast carcinoma. A decision tree was constructed, and the proportions of patients with clinical features that lead to a decision for radiotherapy were obtained from epidemiological data. This ideal utilization rate was compared with the utilization rates of radiotherapy over the last decade for breast carcinoma in Australia and internationally.
The proportion of patients with breast carcinoma in whom radiotherapy would be recommended according to the best available evidence was calculated at 83% (95% confidence interval, 82–85%) of all patients with breast carcinoma. A review of actual radiotherapy utilization rates for breast carcinoma revealed that, in clinical practice, actual utilization rates varied between 24% and 71%.
A substantial difference was found between the recommended optimal utilization of radiotherapy based on evidence and the actual rates reported in clinical practice. The reasons for these differences need to be examined, and a plan for addressing the suboptimal use of radiotherapy needs to be implemented. Cancer 2003. © 2003 American Cancer Society.