Journal ArticleDOI
Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States
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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
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Journal ArticleDOI
Treatment of cervical cancer: overcoming challenges in access to brachytherapy
Katie Lichter,Chidinma P Anakwenze Akinfenwa,Emily MacDuffie,Rohini Bhatia,Christina Small,Jennifer Crocker,William Small,Junzo Chino,Daniel G. Petereit,Surbhi Grover +9 more
TL;DR: The review explores current brachytherapy utilization practices and efforts being undertaken to address barriers to implementation in low-, middle-, and high-income countries, and how these efforts are projected to impact future brachyTherapy access.
Journal ArticleDOI
Oncologic outcomes in the era of modern radiation therapy using FIGO 2018 staging system for cervical cancer.
Melica Nourmoussavi Brodeur,Romain Dejean,Marie-Claude Beauchemin,Vanessa Samouëlian,Beatrice Cormier,Omar Moreira Bacha,Thomas Warkus,Maroie Barkati +7 more
TL;DR: In this article, the authors evaluated the outcomes and patterns of recurrence using FIGO 2018 staging in a cohort of patients treated in an era of high precision image-guided radiotherapy.
Journal Article
Contemporary external beam radiotherapy boost or high dose-rate brachytherapy boost for cervical cancer: a propensity-score-matched, nationwide, population-based cohort study.
Jiaqiang Zhang,Mingyang Sun,Ningtao Li,Mengrong Miao,Yitian Yang,Han-Chuan Hsu,Ho-Min Chen,Szu-Yuan Wu +7 more
TL;DR: In this article, the authors used Cox proportional-hazards model curves to estimate the survival effects of contemporary external beam radiotherapy (EBRT) boost modalities (intensity-modulated radiation therapy or volumetric modulated arc therapy) and high dose-rate brachytherapy (HDR-BT) boost in patients with cervical cancer.
Gynecologic Oncology A consensus-based, process commissioning template for high-dose-rate gynecologic treatments
Derek Brown,Antonio L. Damato,Steven Sutlief,Serban Morcovescu,Sang-June Park,Jay E. Reiff,Allen Shih,Daniel J. Scanderbeg +7 more
TL;DR: In this article, the authors developed a vendor-neutral, consensus-based, commissioning template to improve standardization of the commissioning process of high-dose-rate (HDR) gynecologic (GYN) treatment equipment.
Journal ArticleDOI
3D brachytherapy for cervical cancer: New optimization ways.
TL;DR: In this paper, the authors used 3D image-guided brachytherapy for the local treatment of cervix cancer and showed that 3D imaging can improve the coverage of the target volumes (dose in 90% of the high risk clinical target volume) and limit dose to the organs at risk.
References
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