Sonali S Patankar1, Ana I Tergas2, Israel Deutsch3, William M Burke4, June Y Hou4, Cande V Ananth5, Yongmei Huang1, Alfred I Neugut6, Dawn L Hershman6, Jason D Wright7. 1. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States. 2. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States. 3. Department of Radiation Oncology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States. 4. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States. 5. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States. 6. Department of Medicine, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States. 7. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States. Electronic address: jw2459@columbia.edu.
Abstract
OBJECTIVES: Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. METHODS: Women with stages IB2-IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003-2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. RESULTS: A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (P<0.0001). In a multivariable model, year of diagnosis was the strongest predictor of use of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% CI 0.83-1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. CONCLUSIONS: The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy.
OBJECTIVES: Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. METHODS:Women with stages IB2-IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003-2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. RESULTS: A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (P<0.0001). In a multivariable model, year of diagnosis was the strongest predictor of use of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% CI 0.83-1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. CONCLUSIONS: The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy.
Authors: Jason D Wright; Sharyn N Lewin; Israel Deutsch; William M Burke; Xuming Sun; Thomas J Herzog Journal: Am J Obstet Gynecol Date: 2011-04-16 Impact factor: 8.661
Authors: Jason D Wright; Sharyn N Lewin; Israel Deutsch; William M Burke; Xuming Sun; Thomas J Herzog Journal: Obstet Gynecol Date: 2011-05 Impact factor: 7.661
Authors: Aba Anoa Scott; Joel Yarney; Verna Vanderpuye; Charles Akoto Aidoo; Mervin Agyeman; Samuel Ntiamoah Boateng; Evans Sasu; Kwabena Anarfi; Tony Obeng-Mensah Journal: Int J Gynecol Cancer Date: 2021-02-08 Impact factor: 3.437
Authors: Kara D Romano; Colin Hill; Daniel M Trifiletti; M Sean Peach; Bethany J Horton; Neil Shah; Dylan Campbell; Bruce Libby; Timothy N Showalter Journal: Radiat Oncol Date: 2018-07-16 Impact factor: 3.481