Impact of Global Chart Rounds on Hypofractionated Breast Cancer Treatment: A Retrospective Analysis of Pre- and Post-Round Outcomes

Summary: Hypofractionated radiation therapy (RT) for breast cancer patients, typically involving five fractions, is gaining acceptance due to its convenience and effectiveness. Our department introduced bi-weekly global chart rounds (GCR), involving multidisciplinary teams of physicians, physicists, and staff to individually discuss patient cases. This study evaluates the impact of GCR by comparing pre- and post-round treatment outcomes, patient characteristics, and adherence to updated partial breast irradiation (PBI) criteria. A retrospective analysis was conducted on breast cancer patients treated with RT before and after the introduction of GCR. Pre-GCR data (n=212) and post-GCR data (n=191) were analyzed. Key variables included patient age, tumor size, grade, estrogen receptor (ER) status and delivered doses. The average age was similar between groups, with a mean of 63.93 years pre-GCR and 64.63 years post-GCR. Most patients were white (93.87% pre-GCR, 94.76% post-GCR). Tumor histology included invasive ductal carcinoma (IDC) in 63.21% pre-GCR and 67.02% post-GCR. (Table 1.) Both groups demonstrated similar adherence to PBI criteria, with comparable rates across variables such as tumor size, histologic grade, and ER status (Table 2). In terms of treatment, five-fraction schedules rose significantly from 40.09% pre-GCR to 63.35% post-GCR, with corresponding reductions in 15-fraction schedules (p< 0.05). Median RT elapsed days decreased from 18 days (IQR 9-21) to 9 days (IQR 6-20). Endocrine therapy remained consistent across cohorts, with anastrozole being the most prescribed (61.94% pre-GCR vs. 67.09% post-GCR). No significant differences were observed in lymph node involvement or oncotype scores. The use of 5-fraction schedules increased significantly post-GCR, demonstrating the efficacy of GCR in promoting adherence to hypofractionated regimens. These findings support the continued use of GCR as a valuable tool in optimizing individualized patient care in breast cancer RT. Parisa Shamsesfandabadi (she/her/hers), MD (Presenting Author) - Allegheny Health Network; Arpeet Patel, MD (Co-Author) - Drexel University; Bindu Rusia (she/her/hers), MD (Co-Author) - Allegheny Health Network; Sushil Beriwal (he/him/his), MD (Co-Author) - Allegheny Health Network; Colin Champ (he/him/his), MD (Co-Author) - Allegheny Health Network