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A study presented at the annual Society of Gynecologic Oncology Women's Cancer Meeting demonstrated the benefits of brachytherapy for the survival of advanced cervical cancer.
However, a second presentation highlighted the apparent use of this approach, especially in black women.
According to the results of the study, standard treatment with external beam radiotherapy, brachytherapy and concomitant chemotherapy within 8 weeks of survival significantly prolonged survival compared with chemoradiation alone in women with bad cancer. advanced cervix. Travis-Riley K. Korenaga, MD, Resident physician at the University of California at San Francisco.
Women who received brachytherapy stimulation beyond the 8-week delay recommended by the gynecologic oncology group and the radiotherapy oncology group achieved a longer bone than women who received radiotherapy. by external beam only, showed the results.
However, although it has been shown that brachytherapy improves the results of advanced cervical cancer, it seems to be underutilized.
Black women – whose mortality from cervical cancer is the highest – are significantly less likely than white women to receive the stimulant as part of a treatment, according to the results of the study presented. by Stephanie Alimena, MD, resident physician at Brigham and Women's Hospital and Mbadachusetts General, and Martin T.H. King, MD, PhD, Director of Clinical Brachytherapy Operations at the Dana-Farber Cancer Institute and Radiation Oncology Instructor at Harvard Medical School.
"A very small percentage"
Korenaga and colleagues examined the national cancer database to identify 10,598 women with locally advanced stage II to IVA cervical cancer diagnosed between 2005 and 2014.
All women received external radiation and concurrent chemotherapy as the main treatment.
The majority (73.5%, n = 7,786) also benefited from stimulation of brachytherapy. Only 3,882 (36.6%) women received the stimulant within the recommended 8 weeks.
"It's a very small percentage, [but] it's not a huge change from what we've seen in the past, "said Korenaga. HemOnc today.
The OS was the main result of the study. The researchers also badessed the impact of socioeconomic and clinical variables on standard treatment.
The results showed that women who received standard treatment had a significantly longer median bone (121.3 months) than women in the other groups.
Women who received external beam radiotherapy and brachytherapy beyond 8 weeks had a longer average bone length (93.6 months) than those who received external beam radiotherapy only within 8 weeks (45.3 months) or radiotherapy. external only after 8 weeks (51 months).
"To receive any amount of brachytherapy, even if it extends the duration of treatment beyond the recommended 8 weeks, shows a benefit in terms of survival," said Korenaga. HemOnc today. "For patients who are trying to decide whether they need to complete treatment without brachytherapy early or add brachytherapy treatment beyond the recommended timeframe, it would be better."
Korenaga and colleagues noted that some women seemed less likely than others to receive the standard regimen. These included non-Hispanic black women, women irradiated in more than one place and low-income women, without state insurance or insurance, or at the more advanced stages of the disease.
Disparities in treatment
Alimena, King and colleagues conducted a retrospective cohort study on 17,143 women with locally advanced cervical cancer.
The researchers found that black women were less likely than white women to have brachytherapy (OR = 0.86, 95% CI, 0.78-0.95). Black women also had the highest risk of all-cause mortality (median survival: 53.4 months) and were significantly less likely to receive a brachytherapy injection within the recommended time frame (OR = 1.12, 95% CI: 1). , 03-1.22). Women over the age of 70, those who were not insured or who had public insurance, and women with significant co-morbidities were also less likely to receive the recall within the recommended time frame.
"Black patients were less likely to receive brachytherapy [than] non-black patients, and … overall, black patients have worse outcomes than white patients, "said King HemOnc today. "However, when we stratified our badysis by the number of black patients treated with brachytherapy, we found that black patients treated at maximum with brachytherapy were as effective as white patients. This tells us, therefore, that much of this disparity in survival outcomes is related to undertreatment. "- by Jennifer Byrne
Reference:
Alimena S, et al. Summary 11. Presented at the annual meeting of the Society of Gynecologic Oncology on Women's Cancer; March 16-19, 2019; Honolulu.
Korenaga TRK, et al. Summary 10. Presented at the annual meeting of the Society of Gynecologic Oncology on Women's Cancer; March 16-19, 2019; Honolulu.
Disclosure s : HemOnc today could not confirm the relevant financial information of the authors at the time of the declaration.
A study presented at the annual Society of Gynecologic Oncology Women's Cancer Meeting demonstrated the benefits of brachytherapy for the survival of advanced cervical cancer.
However, a second presentation highlighted the apparent use of this approach, especially in black women.
According to the results of the study, standard treatment with external beam radiotherapy, brachytherapy and concomitant chemotherapy within 8 weeks of survival significantly prolonged survival compared with chemoradiation alone in women with bad cancer. advanced cervix. Travis-Riley K. Korenaga, MD, Resident physician at the University of California at San Francisco.
Women who received brachytherapy stimulation beyond the 8-week delay recommended by the gynecologic oncology group and the radiotherapy oncology group achieved a longer bone than women who received radiotherapy. by external beam only, showed the results.
However, although it has been shown that brachytherapy improves the results of advanced cervical cancer, it seems to be underutilized.
Black women – whose mortality from cervical cancer is the highest – are significantly less likely than white women to receive the stimulant as part of a treatment, according to the results of the study presented. by Stephanie Alimena, MD, resident physician at Brigham and Women's Hospital and Mbadachusetts General, and Martin T.H. King, MD, PhD, Director of Clinical Brachytherapy Operations at the Dana-Farber Cancer Institute and Radiation Oncology Instructor at Harvard Medical School.
"A very small percentage"
Korenaga and colleagues examined the national cancer database to identify 10,598 women with locally advanced stage II to IVA cervical cancer diagnosed between 2005 and 2014.
All women received external radiation and concurrent chemotherapy as the main treatment.
The majority (73.5%, n = 7,786) also benefited from stimulation of brachytherapy. Only 3,882 (36.6%) women received the stimulant within the recommended 8 weeks.
"It's a very small percentage, [but] it's not a huge change from what we've seen in the past, "said Korenaga. HemOnc today.
The OS was the main result of the study. The researchers also badessed the impact of socioeconomic and clinical variables on standard treatment.
The results showed that women who received standard treatment had a significantly longer median bone (121.3 months) than women in the other groups.
Women who received external beam radiotherapy and brachytherapy beyond 8 weeks had a longer average bone length (93.6 months) than those who received external beam radiotherapy only within 8 weeks (45.3 months) or radiotherapy. external only after 8 weeks (51 months).
"To receive any amount of brachytherapy, even if it extends the duration of treatment beyond the recommended 8 weeks, shows a benefit in terms of survival," said Korenaga. HemOnc today. "For patients who are trying to decide whether they need to complete treatment without brachytherapy early or add brachytherapy treatment beyond the recommended timeframe, it would be better."
PAGE BREAK
Korenaga and colleagues noted that some women seemed less likely than others to receive the standard regimen. These included non-Hispanic black women, women irradiated in more than one place and low-income women, without state insurance or insurance, or at the more advanced stages of the disease.
Disparities in treatment
Alimena, King and colleagues conducted a retrospective cohort study on 17,143 women with locally advanced cervical cancer.
The researchers found that black women were less likely than white women to have brachytherapy (OR = 0.86, 95% CI, 0.78-0.95). Black women also had the highest risk of all-cause mortality (median survival: 53.4 months) and were significantly less likely to receive a brachytherapy injection within the recommended time frame (OR = 1.12, 95% CI: 1). , 03-1.22). Women over the age of 70, those who were not insured or who had public insurance, and women with significant co-morbidities were also less likely to receive the recall within the recommended time frame.
"Black patients were less likely to receive brachytherapy [than] non-black patients, and … overall, black patients had worse outcomes than white patients, "said King HemOnc today. "However, when we stratified our badysis by the number of black patients treated with brachytherapy, we found that black patients treated at maximum with brachytherapy were as effective as white patients. This tells us, therefore, that much of this disparity in survival outcomes is related to undertreatment. "- by Jennifer Byrne
Reference:
Alimena S, et al. Summary 11. Presented at the annual meeting of the Society of Gynecologic Oncology on Women's Cancer; March 16-19, 2019; Honolulu.
Korenaga TRK, et al. Summary 10. Presented at the annual meeting of the Society of Gynecologic Oncology on Women's Cancer; March 16-19, 2019; Honolulu.
Disclosure s : HemOnc today could not confirm the relevant financial information of the authors at the time of the declaration.
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