{"title":"2004 至 2021 年美国阴道癌近距离放射治疗的使用趋势。","authors":"Darien Colson-Fearon, Akila N. Viswanathan","doi":"10.1016/j.ygyno.2024.10.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trends in brachytherapy in utilization for vaginal cancer in the United States from 2004 to 2021\",\"authors\":\"Darien Colson-Fearon, Akila N. Viswanathan\",\"doi\":\"10.1016/j.ygyno.2024.10.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":12853,\"journal\":{\"name\":\"Gynecologic oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-10-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gynecologic oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0090825824011648\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gynecologic oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0090825824011648","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Trends in brachytherapy in utilization for vaginal cancer in the United States from 2004 to 2021
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.
期刊介绍:
Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published.
Research Areas Include:
• Cell and molecular biology
• Chemotherapy
• Cytology
• Endocrinology
• Epidemiology
• Genetics
• Gynecologic surgery
• Immunology
• Pathology
• Radiotherapy