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The Royal College of Radiologists National Vulvar Cancer Audit.
- Source :
-
Clinical Oncology . Jul2024, Vol. 36 Issue 7, pe224-e234. 11p. - Publication Year :
- 2024
-
Abstract
- This audit examined UK vulvar cancer practice from March 2018 to January 2019 and compared it to standards from national and international recommendations. Follow-up data collection in 2020 examined patient outcomes and toxicity. Audit standards were based on Royal College of Radiologists (RCR) guidance and published literature. A web-based questionnaire was sent to the audit leads at all cancer centres in the UK. Prospective data collection included patient demographics, tumour characteristics, radiotherapy indications, dosimetry, timelines, and follow-up data. The audit targets were 95% compliance with the RCR dose/fractionation schemes in definitive and adjuvant patients, 40% use of intensity modulated radiotherapy (IMRT), 100% of radical patients treated as category 1, and 95% use of gap compensation for category 1 patients. 34/54 UK radiotherapy centres (63%) completed data entry for 152 patients. 23 out of 34 (68%) centres submitted follow-up data for 94 patients. One indicator exceeded the audit target: 98% of radical patients received IMRT. The indicators of RCR dose/fractionation compliance for adjuvant/definitive radiotherapy were achieved by 80%/43% for the primary, 80%/86% for elective lymph nodes, and 21%/21% for pathological lymph nodes. The use of concomitant chemotherapy with radical radiotherapy in suitable patients was achieved by 71%. Other indicators demonstrated that 78% were treated as category 1 and 27% used gap compensation. Acute toxicity was mostly related to skin, gastrointestinal, and genitourinary sites. Grade 3 and Grade 4 toxicities were seen at acceptable rates within the radical and adjuvant groups. Late toxicity was mostly grade 0. This audit provides a comprehensive picture of UK practice. IMRT is widely used in the UK, and treatment-related toxicity is moderate. The dose fractionation was very heterogeneous. The designation of vulvar cancer as category 1 was not regularly followed for radical/adjuvant patients, and there was minimal gap compensation during treatment. • There is widespread use of IMRT as an RT technique for vulvar cancer in the UK with acceptable reported toxicity. • There is a considerable range of dose and fractionation used for vulvar cancer and there is no consensus regarding the minimum dose to maximize local control. • Compliance to RCR guidelines on designation of category 1 and compensation of gaps in radical treatment is below acceptable variance and should be improved. [ABSTRACT FROM AUTHOR]
- Subjects :
- *AUDITING
*MEDICAL protocols
*CANCER treatment
*LYMPH nodes
*DRUG toxicity
*RADIOTHERAPY
*CANCER patient medical care
*QUESTIONNAIRES
*VULVAR tumors
*TREATMENT effectiveness
*RADIATION dosimetry
*DESCRIPTIVE statistics
*CANCER patients
*LONGITUDINAL method
*ADJUVANT chemotherapy
*PHYSICIAN practice patterns
*RADIATION doses
*MEDICAL practice
*SPECIALTY hospitals
*TIME
Subjects
Details
- Language :
- English
- ISSN :
- 09366555
- Volume :
- 36
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 177581391
- Full Text :
- https://doi.org/10.1016/j.clon.2024.03.024