title: Radiation techniques used in patients with breast cancer: Results of a survey in Spain.
abstract: OBJECTIVE
  To evaluate the resources and techniques used in the irradiation of patients with breast cancer after lumpectomy or mastectomy and the status of implementation of new techniques and therapeutic schedules in our country.
  
  
  BACKGROUND
  The demand for cancer care has increased among the Spanish population, as long as cancer treatment innovations have proliferated. Radiation therapy in breast cancer has evolved exponentially in recent years with the implementation of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and hypofractionation.
  
  
  METHODS
  An original survey questionnaire was sent to institutions participating in the SEOR-Mama group (GEORM). In total, the standards of practice in 969 patients with breast cancer after surgery were evaluated.
  
  
  RESULTS
  The response rate was 70% (28/40 centers). In 98.5% of cases 3D conformal treatment was used. All the institutions employed CT-based planning treatment. Boost was performed in 56.4% of patients: electrons in 59.8%, photons in 23.7% and HDR brachytherapy in 8.8%. Fractionation was standard in 93.1% of patients. Supine position was the most frequent. Only 3 centers used prone position. The common organs of risk delimited were: homolateral lung (80.8%) and heart (80.8%). In 84% histograms were used. An 80.8% of the centers used isocentric technique. In 62.5% asymmetric fields were employed. CTV was delimited in 46.2%, PTV in 65% and both in 38.5%. A 65% of the centers checked with portal films. IMRT and hypofractionation were used in 1% and in 5.5% respectively.
  
  
  CONCLUSIONS
  In most of centers, 3D conformal treatment and CT-based planning treatment were used. IMRT and hypofractionation are currently poorly implemented in Spain.
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Algara
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Arenas
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: De Las Peñas Eloisa Bayo
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Muñoz
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Carceller
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Salinas
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Moreno
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martínez
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: González
authors.affiliation: Breast Cancer Radiation Oncology Spanish Group (GEORM), Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Montero
keywords: Breast cancer; Radiotherapy technique; Spain Survey