title: Audit of the radiotherapy in the DBCG 82 b&c trials--a validation study of the 1,538 patients randomised to postmastectomy radiotherapy.
abstract: BACKGROUND
  In the DBCG 82 b&c trials 3083 patients with stages II and III breast cancer were randomised to receive postmastectomy radiotherapy (RT) versus no RT in addition to systemic therapy. The study showed a decrease in loco-regional recurrences and an improved survival in patients receiving RT. The aim of the present study was to describe the delivered RT for the 1538 patients who were randomised to RT, and to evaluate the compliance with the RT guidelines.
  
  
  METHODS
  Basic information about the given RT was recorded in the DBCG data centre. For the current study, missing and additional information was collected from individual RT treatment charts. We defined some criteria for complying with the DBCG RT guidelines regarding target coverage and dose and fractionation and based on that we also defined some criteria for having clinically acceptable RT treatments.
  
  
  RESULTS
  Of the 1538 patients, 87% received megavoltage RT, 8% had orthovoltage RT and 5% never began or completed RT. Of the 1341 megavoltage irradiated patients, the guideline compliance regarding target coverage of the axillary/periclaviculary region, internal mammary nodes and chest wall was 88, 79 and 85%, respectively. Only 0, 0.2 and 0.4% did not have clinically acceptable target coverage. The dose and fractionation was according to the guidelines in 96% and none had clinically unacceptable dose and fractionation schedules.
  
  
  CONCLUSIONS
  The guideline compliance for megavoltage RT was high with 88, 79 and 85% complying with the guidelines regarding target coverage of the axillary/periclaviculary region, internal mammary nodes and chest wall, respectively, and with 96% complying with the guidelines regarding dose and fractionation schedules. Less than 1% had clinically unacceptable target coverage and none had unacceptable dose and fractionation schedules.
authors.affiliation: Department of Experimental Clinical Oncology, Department of Oncology, Aarhus University Hospital, Denmark. hmn@oncology.dk
authors.forename: Hanne Melgaard
authors.initials: HM
authors.lastname: Nielsen
authors.forename: Jens
authors.initials: J
authors.lastname: Overgaard
authors.forename: Cai
authors.initials: C
authors.lastname: Grau
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Christensen
authors.forename: Marie
authors.initials: M
authors.lastname: Overgaard
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008408:Mastectomy; D008485:Medical Audit; D008875:Middle Aged; D009367:Neoplasm Staging; D017698:Postmenopause; D017697:Premenopause; D011785:Quality Assurance, Health Care; D011878:Radiotherapy / Q000592:standards; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic