Add like
Add dislike
Add to saved papers

Impact of Peer Review on Use of Hypofractionated Regimens for Early-Stage Breast Cancer for Patients at a Tertiary Care Academic Medical Center and Its Community-Based Affiliates.

PURPOSE:: Data have demonstrated that hypofractionated radiation therapy (HFRT) and conventionally fractionated radiation therapy regimens are equivalent with respect to outcomes. Efforts to increase HFRT use have had mixed success. We implemented a prospective peer review chart rounds integrating all practice sites and reviewed the use of HFRT in an attempt to identify potential predictors of use.

MATERIALS AND METHODS:: Patients treated with whole-breast radiation therapy within our cancer care network from January 2016 to June 2017 were evaluated. Radiation courses with a dose per fraction of greater than 2 Gy were considered HFRT, whereas those with a dose per fraction of less than or equal to 2 Gy were considered as conventionally fractionated radiation therapy. Patient, provider, and tumor characteristics were categorized by use of HFRT and compared between groups using a χ2 test or two-tailed t test.

RESULTS:: A total of 349 consecutive patients were identified. All 120 patients treated at the main academic site received HFRT. There was significant variation in use of HFRT among community-based providers (28% to 100%; P < .001). There was increased use of HFRT after implementation of institution-wide prospective peer review (66% v 81% before and after implementation, respectively; P = .001). Age, tumor grade, chemotherapy receipt, surgeon type (academic v community), and treatment after implementation of peer review all correlated with HFRT use. On multivariable analysis, treatment after implementation of peer review ( P < .001) remained a significant predictor of HFRT use, as did age ( P = .005), tumor grade ( P = .013), and surgeon type ( P < .001).

CONCLUSION:: Significant variation persists in the use of HFRT among providers. Increased awareness and oversight through prospective peer review may be useful in improving compliance to HFRT. Expanding these efforts to include education of referring surgeons may be helpful.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app