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Clinical Pathway Modification Increases Adoption of Hypofractionated RT for Prostate Cancer

Modification of a prostate cancer clinical pathway (CP) aided in provider adoption of moderately hypofractionated external beam radiotherapy (mHF-EBRT) in an integrated cancer center (JCO Oncol Pract. 2020;OP2000508. doi:10.1200/OP.20.00508).

Authors analyzed patterns of care and changes in mHF-EBRT use after pathway modification. The prostate cancer CP was amended in January 2018 to make mHF-EBRT the recommended treatment for patients with low- and intermediate-risk prostate cancer pursuing curative EBRT monotherapy.  Using the Cochran-Armitage test, researchers analyzed the trending use of mHF-EBRT from 2015 to 2017 compared with use in 2018 after the CP modification.

In 2017-2017, mHF-EBRT use was 3.7%. An increase to 85.6% was observed in 2018 (P < .001). Conventionally fractionated EBRT use decreased from 96.3% to 14.4% in 2018.

“Modification of our prostate cancer CP, in concert with institutional policies to monitor and audit CP compliance, facilitated rapid adoption of mHF-EBRT in our large, integrated cancer center with good adherence to dosimetric constraints,” concluded the study authors.—Lisa Kuhns


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