Trends in brachytherapy in utilization for vaginal cancer in the United States from 2004 to 2021.

Autor: Colson-Fearon D; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States., Viswanathan AN; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: anv@jhu.edu.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2024 Dec; Vol. 191, pp. 228-232. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1016/j.ygyno.2024.10.014
Abstrakt: Purpose: Brachytherapy (BT) is recommended for vaginal cancer treatment, particularly cases of bulky and/or recurrent disease. However, previous studies noted a decline in utilization rates. This study examines recent trends in BT utilization to assess for reversal in trends.
Material and Methods: This study analyzed the National Cancer Database (NCDB) of patients with FIGO stage I to IVA vaginal cancer treated between 2004 and 2021. A log binomial regression with robust variance was used to estimate incidence rate ratios (IRRs) of BT utilization over time and identify potential factors associated with receipt.
Results: Brachytherapy use increased from 48.0 % in 2004 to 63.3 % in 2021. Factors associated with increased brachytherapy use included, receiving care at an academic/research program (IRR: 1.35 95 % CI: 1.18-1.55), integrated cancer program (1.22 [1.06-1.41]), and diagnosis after 2018 (1.31 [1.21-1.42]). Factors associated with decreased use included American Indian or Alaskan Native race (0.55 [0.31-0.97]) when compared to white race, age over 70 (≥ 70-79 years: 0.91 [0.83-0.99]; ≥ 80 years: 0.68 [0.61-0.76]) when compared to age less than 50, and stage II (0.91 [0.86-0.96]), III (0.71 [0.67-0.75]), or IVA (0.43 [0.37-0.50]) disease when compared to stage I. Finally, geographic differences were also observed in BT use.
Conclusions: In patients with stage I - IVA vaginal cancer from 2004 to 2021, brachytherapy utilization has significantly increased. These results indicate a recent start of the reversal of previously identified declining use of brachytherapy. However, more work is needed to ensure equitable use across demographic strata.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Dr. Viswanathan receives funding through NCI R01 237005.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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