alexa Trends in the utilization of brachytherapy in cervical cancer in the United States.
Reproductive Medicine

Reproductive Medicine

Gynecology & Obstetrics

Author(s): Han K, Milosevic M, Fyles A, Pintilie M, Viswanathan AN

Abstract Share this page

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. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved. This article was published in Int J Radiat Oncol Biol Phys and referenced in Gynecology & Obstetrics

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version