Ting Martin Ma1, Matthew M Harkenrider2, Catheryn M Yashar3, Akila N Viswanathan1, Jyoti S Mayadev4. 1. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. 2. Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL. 3. Department of Radiation Medicine, University of California San Diego School of Medicine, San Diego, CA. 4. Department of Radiation Medicine, University of California San Diego School of Medicine, San Diego, CA. Electronic address: jmayadev@ucsd.edu.
Abstract
PURPOSE: To understand the reasons behind current low utilization of brachytherapy for locally advanced cervical cancer in the United States. METHODS AND MATERIALS: A 17-item survey was e-mailed to the American Brachytherapy Society (ABS) listserv of active members in 2018. Responses of attending physicians in the United States were included in the analysis. RESULTS: Among a total of 135 respondents, 81 completed the survey. Eighty-four percent agree/strongly agree that cervical brachytherapy is underutilized, and 46.9% disagree/strongly disagree that residents are receiving adequate training for brachytherapy; 75.3% agree/strongly agree that inadequate maintenance of brachytherapy skills is a major obstacle to brachytherapy use; and 71.6% agree/strongly agree that increased time requirement constitutes a major obstacle. Over 97% will recommend brachytherapy for most patients with cervical cancer if given access/time; 72.8% always perform their own brachytherapy, whereas 29.6% reported some type of barrier exists in performing brachytherapy themselves, with time required to perform brachytherapy (9.9%) being a leading factor. A quarter (24.7%) routinely refer to other radiation oncologists for brachytherapy. Even among ABS members, 37.0% reported that they would perform an intensity-modulated radiation therapy or stereotactic body radiation therapy boost in specific scenarios in potentially curable patients. The most common scenario is inability to place a uterine tandem (56.7%). CONCLUSIONS: The underutilization of brachytherapy in cervical cancer is widely recognized by ABS members with inadequate training during residency and inadequate maintenance of skills being possible major contributing factors. Even among ABS members, there are identifiable barriers. Continued advocacy and future initiatives in enhancing access to brachytherapy training and efficiency are needed. Published by Elsevier Inc.
PURPOSE: To understand the reasons behind current low utilization of brachytherapy for locally advanced cervical cancer in the United States. METHODS AND MATERIALS: A 17-item survey was e-mailed to the American Brachytherapy Society (ABS) listserv of active members in 2018. Responses of attending physicians in the United States were included in the analysis. RESULTS: Among a total of 135 respondents, 81 completed the survey. Eighty-four percent agree/strongly agree that cervical brachytherapy is underutilized, and 46.9% disagree/strongly disagree that residents are receiving adequate training for brachytherapy; 75.3% agree/strongly agree that inadequate maintenance of brachytherapy skills is a major obstacle to brachytherapy use; and 71.6% agree/strongly agree that increased time requirement constitutes a major obstacle. Over 97% will recommend brachytherapy for most patients with cervical cancer if given access/time; 72.8% always perform their own brachytherapy, whereas 29.6% reported some type of barrier exists in performing brachytherapy themselves, with time required to perform brachytherapy (9.9%) being a leading factor. A quarter (24.7%) routinely refer to other radiation oncologists for brachytherapy. Even among ABS members, 37.0% reported that they would perform an intensity-modulated radiation therapy or stereotactic body radiation therapy boost in specific scenarios in potentially curable patients. The most common scenario is inability to place a uterine tandem (56.7%). CONCLUSIONS: The underutilization of brachytherapy in cervical cancer is widely recognized by ABS members with inadequate training during residency and inadequate maintenance of skills being possible major contributing factors. Even among ABS members, there are identifiable barriers. Continued advocacy and future initiatives in enhancing access to brachytherapy training and efficiency are needed. Published by Elsevier Inc.
Entities:
Keywords:
American brachytherapy society (ABS); Brachytherapy; Cervical cancer; Survey; Underutilization
Authors: David Boyce-Fappiano; Kevin A Nguyen; Olsi Gjyshi; Gohar Manzar; Chike O Abana; Ann H Klopp; Mitchell Kamrava; Peter F Orio; Nikhil G Thaker; Firas Mourtada; Puja Venkat; Albert J Chang Journal: JCO Oncol Pract Date: 2021-09-22
Authors: Christine H Feng; Corinne McDaniels-Davidson; Maria Elena Martinez; Jesse Nodora; Arno J Mundt; Jyoti S Mayadev Journal: J Contemp Brachytherapy Date: 2021-12-30