2004 至 2021 年美国阴道癌近距离放射治疗的使用趋势。

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Gynecologic oncology Pub Date : 2024-10-24 DOI:10.1016/j.ygyno.2024.10.014
Darien Colson-Fearon, Akila N. Viswanathan
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引用次数: 0

摘要

目的:近距离放射治疗(BT)被推荐用于阴道癌治疗,尤其是体积较大和/或复发的病例。然而,以往的研究表明,BT 的使用率有所下降。本研究对 BT 使用率的最新趋势进行了调查,以评估趋势是否发生逆转:本研究分析了全国癌症数据库(NCDB)中2004年至2021年间接受治疗的FIGO I至IVA期阴道癌患者。采用稳健方差对数二项式回归法估算了近距离放射治疗使用率随时间变化的发生率比(IRR),并确定了与接受近距离放射治疗相关的潜在因素:结果:近距离放射治疗的使用率从 2004 年的 48.0% 增加到 2021 年的 63.3%。与近距离放射治疗使用率增加相关的因素包括:在学术/研究项目中接受治疗(IRR:1.35 95 % CI:1.18-1.55)、综合癌症项目(1.22 [1.06-1.41])和 2018 年后诊断(1.31 [1.21-1.42])。与使用减少相关的因素包括:美国印第安人或阿拉斯加原住民种族(0.55 [0.31-0.97])与白人种族相比,年龄超过 70 岁(≥ 70-79 岁:0.91 [0.83-0.99];≥ 80 岁:0.68 [0.61-0.76])与年龄小于 70 岁相比。最后,还观察到 BT 使用的地域差异:结论:从 2004 年到 2021 年,I-IVA 期阴道癌患者的近距离放射治疗使用率显著增加。这些结果表明,之前发现的近距离放射治疗使用率下降趋势最近开始逆转。不过,还需要做更多的工作来确保各人口阶层的公平使用。
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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.
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
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
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