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
Combined modality management of advanced cervical cancer including novel sensitizers
TL;DR: The role of surgery is reviewed in this article for specific situations such as the treatment of bulky lymph nodes and even in the metastatic setting.
Peer Review
Cancer-specific survival T2w MRI T2-weighted MRI FDG-PET Fluorodeoxyglucose PET DCE-MRI Dynamic contrast-enhanced MRI DW-MRI Diffusion-weighted MRI
TL;DR: In this paper , the situation and scope of existing multi-imaging combination methods in cervical cancer brachytherapy and a reference for medical institutions is provided, which can be used for applicator implantation guidance, applicator reconstruction, target and organs at risk (OAR) contouring, dose optimization, prognosis evaluation, etc.
Journal ArticleDOI
Role of gastrointestinal ultrasound in image-guided radiation therapy: A review
Journal ArticleDOI
Optimisation de la curiethérapie utérovaginale de débit pulsé des cancers du col utérin localement évolués : résultats finaux du PHRC Tridicol
C. Charra-Brunaud,Julia Salleron,I. Menoux,K. Peignaux,A. Ducassou,A. Petit,P. Pommier,I. Barillot,A.A. Serre,L. Thomas,M. Delannes,D. Thibouw,Delphine Antoni,S. Renard,Didier Peiffert +14 more
TL;DR: La dose dans le CTV HR a ete inferieure a l’objectif (85 Gy) du fait d’une faible utilisation des applicateurs avec aiguilles interstitielles parametriales, les centres participants ne disposant pas toujours d“un applicateur adequat”.
Book ChapterDOI
Intracavitary Brachytherapy from 2D to 3D
TL;DR: The history and clinical results of the 2D- and 3D-ICBT procedures are reviewed and the issues and future challenges of image-guided brachytherapy (3D-IGBT) in the treatment of uterine cervical cancer are mentioned.
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