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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Book ChapterDOI
Towards a Robotically Steerable System for High Dose Rate Brachytherapy
TL;DR: In this article, a tendon-driven omnidirectional bending joint for a steerable stylet that can be inserted into a commercial brachytherapy needle is presented. Butler et al. demonstrate the ability of the joint to achieve the desired bending angle in the needle.
Journal ArticleDOI
Variations in Resources Among Radiation Oncology Residency Programs in the United States.
Toms Vengaloor Thomas,Teessa Perekattu Kuruvilla,Jenna M. Kahn,Eldrin Bhanat,Amy Parr,Ashley Albert,Mudit Chowdhary,Sushil Beriwal,Srinivasan Vijayakumar +8 more
TL;DR: It is found that marked variations exist among RO residency programs in the United States during academic year 2018-2019 and will serve as a baseline for future intervention.
Journal ArticleDOI
An endovaginal MRI array with a forward-looking coil for advanced gynecological cancer brachytherapy procedures: Design and initial results
Akbar Alipour,Akbar Alipour,Akila N. Viswanathan,Ronald Dean Watkins,Hassan Elahi,Wolfgang Loew,Eric S. Meyer,Marc Morcos,Henry R. Halperin,Ehud J. Schmidt +9 more
TL;DR: In this paper, the authors developed an endovaginal MRI array that provides signal enhancement forward into the posterior parametrium and sideways into the vaginal wall, accelerating multiple-contrast detection of residual tumors that survive external beam radiation.
Dissertation
Carcinoma de cérvix uterino localmente avanzado Presentación de un caso clínico
TL;DR: The case of a 36 years patient, diagnosed with cancer of the uterine cervix stage IIIB (FIGO classification) treated with concomitant chemoradiation (QT+RT) is presented.
Journal ArticleDOI
Combined Interstitial and Intracavitary High-Dose Rate Brachytherapy of Cervical Cancer
Jun Itami,Naoya Murakami,Miho Watanabe,Shuhei Sekii,Takahiro Kasamatsu,Shingo Kato,Hisako Hirowatari,Hitoshi Ikushima,Ken Ando,Tatsuya Ohno,Hiroyuki Okamoto,Kae Okuma,Hiroshi Igaki +12 more
TL;DR: High-dose-rate brachytherapy by remote afterloading is now performed under three-dimensional image guidance by CT or MRI, and it was revealed that hybrid brachyTherapy can be performed safely and with a high quality of radiation dose distribution in a multi-institutional study.
References
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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.
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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