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Brachytherapy improves survival in cervical cancer, but racial differences remain



A study presented at the Annual Meeting of the Society of Gynecological Oncology on Female Cancer has shown the benefit of brachytherapy for survival for the treatment of cervical cancer.

However, another presentation highlighted the obvious use of this approach, especially among black women.

Treatment of standard treatment with external radiation therapy (EBRT) plus brachytherapy and concurrent chemotherapy within 8 weeks significantly extends survival compared to hemodialysis alone in women with advanced cervical cancer, according to research results Travis-Riley K. Korenaga, MD, a resident doctor at the University of California, San Francisco.

Women who received brachytherapy intensification over the 8-week time frame recommended by the gynecologic oncology group and oncology group for radiotherapy achieved longer operations than women who received only radiation therapy, the results showed.

However, although brachytherapy has been shown to improve the outcome of advanced cervical cancer, it seems to be underutilized.

Black women – who have the highest mortality from cervical cancer – have significantly less likelihood than white women to receive the incentive as part of the treatment, according to research results presented by Stephanie Alimena, MD, a resident doctor at Brigham and the Women's Hospital and a general hospital in Massachusetts, i Martin T.H. King, MD, PhD, Director of Clinical Brachytherapy Operations at the Dana-Farber Cancer Institute and an instructor in radiation oncology at the Harvard Medical School.

"Very small percentage"

The coroners and colleagues examined the National Cancer Database to identify 10,598 women with II to IVA locally advanced cervical cancer diagnosed between 2005 and 2014.

All women received EBRT and with simultaneous chemotherapy as their primary treatment.

The majority (73.5%; n = 7.786) also had the incentive for brachytherapy. Only 3.882 (36.6%) women received an incentive within the recommended 8 weeks.

"It's a very small percentage, [but] it's not a big departure from what we saw in the past, "Korenaga told HemOnc Todai.

OS served as the primary outcome of the study. The researchers also assessed the impact of socioeconomic and clinical variables on receiving standard care treatment.

The results showed that women who received standard treatment achieved a significantly longer mean OS (121.3 months) than women in all other groups.

Women who received EBRT and brachytherapy for more than 8 weeks achieved a longer media OS (93.6 months) than those who had EBRT only within 8 weeks (45.3 months) or EBRT only after 8 weeks (51 months) .

"Receiving any amount of brachytherapy, even if it prolongs the duration of treatment after the recommended 8 weeks, shows the benefit of survival," said Korenaga. HemOnc Todai. "For patients who are trying to decide whether they need to complete treatment without early brachytherapy, or to add brachytherapy that can be extended beyond the recommended time frame, this would be desirable."

The coroners and colleagues noted that some women are less likely than others to receive standard care. Among them were women who were not Hispanic black, women who were exposed to radiation at more than one location, and those with low income, without insurance or state insurance, or a higher stage of illness.

Disparities in treatment

Alimena, King and colleagues conducted a retrospective cohort study of 17,143 women with locally advanced cervical cancer.

The researchers found that black women were less prone to brachytherapy than white women (OR = 0.86; 95% CI, 0.78-0.95). Black women also showed the highest risk of mortality from all causes (median survival, 53.4 months) and were significantly less likely to receive brachytherapy enhancement in the recommended time frame (OR = 1.12; 95% CI, 1.03% 1,22). Women over 70 years old, those who were uninsured or insured in the public sector and those with significant comorbidity are also less likely to get incentives within the recommended time frame.

"Black patients were less likely to receive brachytherapy [than] black patients, and … in general, black patients had poorer results than white patients, "said King HemOnc Todai. "However, when we analyzed our analysis of whether black patients received brachytherapy, we found that black patients who received maximum brachytherapy treatment did the same as white patients. So, what is telling us is that a large part of this disparity in survival outcomes is related to subordination. "- would be Jennifer Birne

Reference:

Alimena S, et al. Summary 11. Presented at the Annual Meeting of the Society of Gynecologic Oncologists on Female Cancer; 16-19. Honolulu.

Korenaga TRK, et al. Summary 10. Presented at: Annual Meeting of the Society of Gynecologic Oncology on Cancer of Women; 16-19. Honolulu.

Disclosure s : HemOnc Todai they could not confirm the relevant financial disclosures of the author at the time of reporting.

A study presented at the Annual Meeting of the Society of Gynecological Oncology on Female Cancer has shown the benefit of brachytherapy for survival for the treatment of cervical cancer.

However, another presentation highlighted the obvious use of this approach, especially among black women.

Treatment of standard treatment with external radiation therapy (EBRT) plus brachytherapy and concurrent chemotherapy within 8 weeks significantly extends survival compared to hemodialysis alone in women with advanced cervical cancer, according to research results Travis-Riley K. Korenaga, MD, a resident doctor at the University of California, San Francisco.

Women who received brachytherapy intensification over the 8-week time frame recommended by the gynecologic oncology group and oncology group for radiotherapy achieved longer operations than women who received only radiation therapy, the results showed.

However, although brachytherapy has been shown to improve the outcome of advanced cervical cancer, it seems to be underutilized.

Black women – who have the highest mortality from cervical cancer – have significantly less likelihood than white women to receive the incentive as part of the treatment, according to research results presented by Stephanie Alimena, MD, a resident doctor at Brigham and the Women's Hospital and the General Hospital in Massachusetts, i Martin T.H. King, MD, PhD, Director of Clinical Brachytherapy Operations at the Dana-Farber Cancer Institute and an instructor in radiation oncology at the Harvard Medical School.

"Very small percentage"

The coroners and colleagues examined the National Cancer Database to identify 10,598 women with II to IVA locally advanced cervical cancer diagnosed between 2005 and 2014.

All women received EBRT and with simultaneous chemotherapy as their primary treatment.

The majority (73.5%; n = 7.786) also had the incentive for brachytherapy. Only 3.882 (36.6%) women received an incentive within the recommended 8 weeks.

"It's a very small percentage, [but] it's not a big departure from what we saw in the past, "Korenaga told HemOnc Todai.

OS served as the primary outcome of the study. The researchers also assessed the impact of socioeconomic and clinical variables on receiving standard care treatment.

The results showed that women who received standard treatment achieved a significantly longer mean OS (121.3 months) than women in all other groups.

Women who received EBRT and brachytherapy for more than 8 weeks achieved a longer media OS (93.6 months) than those who had EBRT only within 8 weeks (45.3 months) or EBRT only after 8 weeks (51 months) .

"Receiving any amount of brachytherapy, even if it prolongs the duration of treatment after the recommended 8 weeks, shows the benefit of survival," said Korenaga. HemOnc Todai. "For patients who are trying to decide whether they need to complete treatment without early brachytherapy, or to add brachytherapy that can be extended beyond the recommended time frame, this would be desirable."

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The coroners and colleagues noted that some women are less likely than others to receive standard care. Among them were women who were not Hispanic black, women who were exposed to radiation at more than one location, and those with low income, without insurance or state insurance, or a higher stage of illness.

Disparities in treatment

Alimena, King and colleagues conducted a retrospective cohort study of 17,143 women with locally advanced cervical cancer.

The researchers found that black women were less prone to brachytherapy than white women (OR = 0.86; 95% CI, 0.78-0.95). Black women also showed the highest risk of mortality from all causes (median survival, 53.4 months) and were significantly less likely to receive brachytherapy enhancement in the recommended time frame (OR = 1.12; 95% CI, 1.03% 1,22). Women over 70 years old, those who were uninsured or insured in the public sector and those with significant comorbidity are also less likely to get incentives within the recommended time frame.

"Black patients were less likely to receive brachytherapy [than] black patients, and … in general, black patients had poorer results than white patients, "said King HemOnc Todai. "However, when we analyzed our analysis of whether black patients received brachytherapy, we found that black patients who received maximum brachytherapy treatment did the same as white patients. So, what is telling us is that a large part of this disparity in survival outcomes is related to subordination. "- would be Jennifer Birne

Reference:

Alimena S, et al. Summary 11. Presented at the Annual Meeting of the Society of Gynecologic Oncologists on Female Cancer; 16-19. Honolulu.

Korenaga TRK, et al. Summary 10. Presented at: Annual Meeting of the Society of Gynecologic Oncology on Cancer of Women; 16-19. Honolulu.

Disclosure s : HemOnc Todai they could not confirm the relevant financial disclosures of the author at the time of reporting.


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