Excessive waitlists and delays to treatment with low-dose-rate brachytherapy predict an increased risk of recurrence and metastases in intermediate-risk prostatic carcinoma
| Autor: | Rutvij A. Khanolkar, Michael Sia, Kundan Thind, Philip McGeachy, Siraj Husain, Harvey Quon, Michael Roumeliotis, Kevin Martell, Tyler Meyer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Brachytherapy R895-920 Metastases Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Interquartile range Recurrence Internal medicine Biopsy Carcinoma medicine Radiology Nuclear Medicine and imaging Cumulative incidence RC254-282 medicine.diagnostic_test business.industry Prostatectomy Incidence (epidemiology) Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Wait times for treatment Oncology 030220 oncology & carcinogenesis business |
| Zdroj: | Clinical and Translational Radiation Oncology, Vol 30, Iss, Pp 38-42 (2021) Clinical and Translational Radiation Oncology |
| ISSN: | 2405-6308 |
| Popis: | Highlights • Resource constraints have led to prolonged wait-times for prostate brachytherapy. • Increased wait times predict a significant increase in recurrence and metastases. • Better resource planning is needed to reduce management delays & improve outcomes. Purpose It has previously been shown that increased wait times for prostatectomy are associated with poorer outcomes in intermediate-risk prostatic carcinoma (PCa). However, the impact of wait times on PCa outcomes following low-dose-rate brachytherapy (LDR-BT) are unknown. Methods and Materials We retrospectively reviewed 466 intermediate-risk PCa patients that underwent LDR-BT at a single comprehensive cancer center between 2003 and 2016. Wait times were defined as the time from biopsy to LDR-BT. The association of wait times with outcomes was evaluated using Cox and Fine-Gray regression in both univariate and multivariate models. Results Median (interquartile range) follow-up and wait time for all patients were 8.1 (6.3–10.4) years and 5.1 (3.9–6.9) months, respectively. Among NCCN unfavourable intermediate-risk (UIR) patients (n = 170; 36%), increased wait times predicted both a greater cumulative incidence of recurrence [MHR = 1.01/month of wait time (95% CI: 1.00–1.03); P = 0.044] and metastases [MHR = 1.04/month of wait time (95% CI: 1.02–1.06); P |
| Databáze: | OpenAIRE |
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