Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea

Abstract

Objective External beam radiation therapy (EBRT) with concurrent chemotherapy followed by intracavitary brachytherapy is the standard treatment in locally advanced cervical cancer. This study examined the brachytherapy utilization rate and evaluated the effect of brachytherapy on survival in cervical cancer patients in Korea. Methods In this study, data from the Korea Central Cancer Registry and Korean National Health Insurance Service and data on mortality from Statistics Korea were linked and used. Patients with other cancers, distant metastasis at diagnosis, or unknown stage or who underwent hysterectomy were excluded. A total of 12,721 cervical cancer patients were analyzed in this study. Results The brachytherapy utilization rate (%) was calculated as the proportion of patients who received brachytherapy among those who received curative EBRT. The brachytherapy utilization rate decreased from 84% in 2005 to 78% in 2013 (p<0.001). Brachytherapy utilization rates varied by region, ranging from 72% to 100% except for in Jeju Island, where the rate was 56%. The brachytherapy utilization rate was lower in patients older than 80 years; patients with localized disease, non-squamous cell carcinoma, or Charlson comorbidity index 3 or more; patients diagnosed after 2010; patients from certain regions; patients receiving medical aid; and patients who underwent gynecologic procedures. Multivariable Cox regression analysis showed that brachytherapy when added to curative EBRT was independently associated with better cancer-specific survival (CSS) and overall survival (OS) than curative EBRT only. Conclusion The brachytherapy utilization rate decreased from 2005 to 2013 and varied by region in Korea. Brachytherapy use is independently associated with significantly higher CSS and OS in cervical cancer.

Prognostic Factors Analysis of Metastatic Recurrence in Cervical Carcinoma Patients Treated with Definitive Radiotherapy: A Retrospective Study Using Mixture Cure Model

“…Locally advanced/advanced stage was also a mild risk factor for metastatic recurrence in the mixture cure model. Consistent with our study, a number of studies have confirmed that FIGO has a strong association with metastatic recurrence [7][8][9]. The FIGO 2018 staging system reflects patient prognosis, as Qin noted [29].…”

“…There is well-documented evidence which bears a significant influence on prognoses, such as the FIGO stage [8,9] and concurrent chemotherapy [6,10]. However, some controversies remain to be solved; for instance, some studies reported inconsistent results for age [11,12] and differentiation [13,14].…”

Nursing care for women with gynecologic cancer receiving radiotherapy: current updates

“…The advantages of brachytherapy include the delivery of a high dose of radiation due to the proximity of the equipment to the treatment area and the minimization of effects on normal tissues in the bladder and rectum [ 7 , 8 ] ( Figure 2 ). Data reported in 2021, however, showed that the availability of brachytherapy decreased from 84% in 2005 to 78% in 2013 in Korea and the number of medical institutions that offer brachytherapy also declined from 65% in 2006 to 36.8% in 2014 [ 9 ]. Since it is impossible to maintain facilities for brachytherapy available due to low medical reimbursements and challenges in equipment management, patients are often referred to other institutions.…”

Mulheres submetidas à braquiterapia pélvica: significados da terapêutica e dos seus efeitos

“…A braquiterapia de alta taxa dose, contexto deste estudo, é recomendada para casos de câncer ginecológico com estadiamento avançado, pois permite a aplicação de maior dose de radiação em curta distância e contribui para ampliar a sobrevida das mulheres com câncer ginecológico (Chargari et al, 2019;Kim et al, 2021). Apesar de sua ação benéfica no controle da doença, os efeitos adversos são inevitáveis.…”