Journal ArticleDOI
Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States
Reads0
Chats0
TLDR
Brachytherapy use is independently associated with significantly higher CSS and OS and should be implemented in all feasible cases and significant geographic disparities in the delivery of brachyther therapy in the United States are revealed.Abstract:
Purpose To determine the trends in brachytherapy use in cervical cancer in the United States and to identify factors and survival benefits associated with brachytherapy treatment. Methods and Materials Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 7359 patients with stages IB2-IVA cervical cancer treated with external beam radiation therapy (EBRT) between 1988 and 2009. Propensity score matching was used to adjust for differences between patients who received brachytherapy and those who did not from 2000 onward (after the National Cancer Institute alert recommending concurrent chemotherapy). Results Sixty-three percent of the 7359 women received brachytherapy in combination with EBRT, and 37% received EBRT alone. The brachytherapy utilization rate has decreased from 83% in 1988 to 58% in 2009 ( P .001), with a sharp decline of 23% in 2003 to 43%. Factors associated with higher odds of brachytherapy use include younger age, married (vs single) patients, earlier years of diagnosis, earlier stage and certain SEER regions. In the propensity score-matched cohort, brachytherapy treatment was associated with higher 4-year cause-specific survival (CSS; 64.3% vs 51.5%, P .001) and overall survival (OS; 58.2% vs 46.2%, P .001). Brachytherapy treatment was independently associated with better CSS (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.57-0.71), and OS (HR 0.66; 95% CI, 0.60 to 0.74). Conclusions This population-based analysis reveals a concerning decline in brachytherapy utilization and significant geographic disparities in the delivery of brachytherapy in the United States. Brachytherapy use is independently associated with significantly higher CSS and OS and should be implemented in all feasible cases.read more
Citations
More filters
Journal ArticleDOI
Patterns of cervical cancer care in Argentina: Applying ASCO recommendations adjusted by local resources.
TL;DR: The present article describes the current pattern of care of cervical cancer in Argentina and establishes recommendations adjusted to local resources in different regions of the country according to the ASCO guideline.
Journal ArticleDOI
The "decay" of brachytherapy use in tumors of the oral cavity: A population-based patterns of care and outcomes analysis from 1973 to 2012.
TL;DR: The use of BT is associated with improved survival in oral cavity tumors treated with definitive radiotherapy, and rates of BT utilization have declined by 0.58% per year and are currently very low.
Journal ArticleDOI
Adverse events of after-loading high dose rate brachytherapy reported to the United States Food and Drug Administration (FDA)
Destie Provenzano,Kevin Rao,Gizem Cifter,Neil K. Taunk,Benjamin W. Fischer-Valuck,Alexander J. Lin,Mehrdad Sarfaraz,Hamid Aghdam,Martin Ojong-Ntui,Murray H. Loew,Sharad Goyal,Y.J. Rao +11 more
TL;DR: In this paper, the authors provide an assessment of safety regarding high-dose-rate afterloading brachytherapy (HDR-BT) based on adverse events reported to the OpenFDA, an open access database maintained by the United States Food and Drug Administration (FDA).
Journal ArticleDOI
The Role of LncRNAs in the Regulation of Radiotherapy Sensitivity in Cervical Cancer
Hanqun Zhang,Chunju Fang,Z Q Feng,Tingting Xia,Liang Lu,Minjie Luo,Yanping Chen,Yuncong Liu,Yong Li +8 more
TL;DR: The structure and function of LncRNAs and the molecular mechanism of radiosensitivity in cervical cancer are summarized, the LNCRNAs associated with radios sensitivity in cervicalcancer are listed, their potential mechanisms are analyzed, and the potential clinical application of these Lnc RNAs are discussed.
Journal ArticleDOI
More than learning technical skills: The importance of mentorship and coaching during a brachytherapy fellowship.
TL;DR: A brachytherapy fellowship encompasses hands-on procedural skills in addition to clinical decision-making, radiotherapy treatment planning, as well as post-treatment care.
References
More filters
Book
Applied Logistic Regression
David W. Hosmer,Stanley Lemeshow +1 more
TL;DR: Hosmer and Lemeshow as discussed by the authors provide an accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets.
Book
Modeling Survival Data: Extending the Cox Model
TL;DR: A Cox Model-based approach was used to estimate the Survival and Hazard Functions and the results confirmed the need for further investigation into the role of natural disasters in shaping survival rates.
Journal ArticleDOI
Propensity score methods for bias reduction in the comparison of a treatment to a non‐randomized control group
TL;DR: The propensity score, defined as the conditional probability of being treated given the covariates, can be used to balance the variance of covariates in the two groups, and therefore reduce bias as mentioned in this paper.
Related Papers (5)
Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group☆ (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV
Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study.
Alina Sturdza,Richard Pötter,Lars Fokdal,Christine Haie-Meder,Li Tee Tan,Renaud Mazeron,Primoz Petric,Barbara Segedin,Ina M. Jürgenliemk-Schulz,C. Nomden,C. Gillham,Orla McArdle,Erik Van Limbergen,Hilde Janssen,Peter Hoskin,Gerry Lowe,Ekkasit Tharavichitkul,E. Villafranca,Umesh Mahantshetty,Petra Georg,Kathrin Kirchheiner,Christian Kirisits,Kari Tanderup,Jacob Christian Lindegaard +23 more