Brachytherapy最新文献

{"title":"3D-printed template design to improve ¹²⁵I seed plaque assembly accuracy for uveal brachytherapy.","authors":"Kaitlyn Calabresi, Jacqueline Emrich, Sara Belko, Robert Pugliese, Lydia Komarnicky-Kocher, Firas Mourtada","doi":"10.1016/j.brachy.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.004","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the utility of a QA program for seed localization, and to design a 3D-printed template to improve the accuracy of seed placement on custom-built ¹²⁵I eye plaques for uveal brachytherapy.</p><p><strong>Methods and materials: </strong>A seed localization analysis tool (SLAT) was developed in MATLAB to detect variations in seed placement relative to a treatment plan. A flexible seed placement template (3D-FSPT) was designed in CAD and printed using a Formlabs Form-3 3D printer. The 3D-FSPT and SLAT were tested using 3D-printed model eye plaques with nonradioactive seeds arranged following clinically-relevant treatment plans. Five clinical plaques were also evaluated.</p><p><strong>Results: </strong>SLAT detected submillimeter scale variations in seed position with 2.3% error relative to the plan's seed coordinates, and with an uncertainty of ± 0.01 mm. The average seed displacement on the model plaques with free-handed seed placement was 1.31 mm (SD = 0.61), and the average seed orientation difference was 5.27 degrees (SD = 4.77). The average seed displacement on the clinical plaques was 0.77 mm (SD = 0.42), and the average seed orientation difference was 4.41 degrees (SD = 3.00). For the clinical plaques, changes in dosimetry to the tumor apex and critical eye structures were within acceptable tolerances. Seed displacement (mm) (p < 0.001) and seed orientation differences (degrees) (p = 0.008) were significantly lower using the template to guide seed placement on the model plaques compared to free-handed seed placement.</p><p><strong>Conclusions: </strong>The feasibility of a 3D-FSPT and SLAT is demonstrated for improving seed placement accuracy relative to a treatment plan.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed needle guides for cervical cancer brachytherapy: Optimized dosimetry and improved local control outcomes.","authors":"Santino Butler, Thomas Niedermayr, Elizabeth A Kidd","doi":"10.1016/j.brachy.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.001","url":null,"abstract":"<p><strong>Purpose: </strong>We previously designed three-dimensionally-printed needle guides (3D-NG) for cervical cancer brachytherapy, which improved procedure efficiency and tumor coverage while achieving similar organs at risk (OAR) sparing compared to non-3D-printed techniques (non-3D). The subject of this study was whether 3D-NG can help improve local control and other brachytherapy outcomes.</p><p><strong>Methods: </strong>This single institution cohort study includes 130 patients who underwent definitive external-beam radiotherapy and high-dose-rate intracavitary +/- interstitial brachytherapy from February 2017 to July 2023. 3D-NG were implemented for all cases after December 2019 (N = 77). Non-3D included applicator-only/no-needles (N = 28) or freehand-placed needles (N = 25).</p><p><strong>Results: </strong>Median follow-up was 24 months. 3D-NG, versus non-3D, achieved higher mean D90 (+5.2 Gy, p < 0.001), D98 (+4.3 Gy, p < 0.001), and V100_average (+5.9%, p < 0.001)-with greater improvement for larger tumors (high-risk[HR]-CTV>30 cubic-centimeters[cc]) (P_interaction<0.10 for all). Maximum D2cc for all OAR were comparable between 3D-NG and non-3D (p > 0.05). 2-year LF was lower with 3D-NG compared to non-3D (8.2% vs. 22.0%; aHR 0.31, p = 0.036)-and compared to freehand-needles alone (8.2% vs. 20.6%, p < 0.001 [log-rank])-particularly among cases with higher cumulative HR-CTV dose (D90 >85 Gy; p_interaction = 0.013) and lower HR-CTV volume (≤30 cc; p_interaction = 0.048). 2-year LF was also lower with concurrent cisplatin (aHR 0.20, p = 0.001) and ≥40% decrease in tumor diameter after EBRT (aHR 0.16, p = 0.010); but higher among minority race (aHR 4.21, p = 0.06).</p><p><strong>Conclusions: </strong>3D-NG for cervix brachytherapy were associated with improved 2-year LF compared to non-3D/freehand-needles, with higher achievement of EMBRACE II goals for D90 and D98, with similar OAR doses. This study highlights the potential for 3D-NG to simplify needle insertion while simultaneously improving needle position, dosimetry, and disease control outcomes.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you do it?: Gynecologic brachytherapy best practices at high volume institutions within the United States and Canada.","authors":"Christina Small, Saryleine Ortiz, Meena Bedi, Melissa Joyner, Emma Fields, Scott Glaser, Beth Erickson","doi":"10.1016/j.brachy.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.011","url":null,"abstract":"<p><strong>Introduction: </strong>Definitive treatment including chemoradiation and brachytherapy for patients diagnosed with locally advanced cervical cancer requires significant multidisciplinary coordination. Our goal was to assess and share gynecologic brachytherapy best practices from high volume brachytherapy centers.</p><p><strong>Methods: </strong>A survey was sent to 42 centers within the United States and Canada that perform a high volume of complex gynecologic brachytherapy.</p><p><strong>Results: </strong>Responses were collected from 32/42 (76%) institutions. 41% of responding institutions perform > 100 complex brachytherapy procedures per year. Most departments have >1 brachytherapist and 85% of respondents complete 1-2 complex brachytherapy procedures per day. 91% of surveyed departments have support staff specifically devoted to brachytherapy. Approximately 50% of intracavitary/hybrid procedures are performed in departmental brachytherapy suites. Institutions use MRI (35%), CT (24%) or a combination (24%) for treatment planning. 88% of respondents use sedation for tandem based procedures. Respondents cite high complexity of care, insufficient reimbursement, untimely referrals, shared operative and clinical duties, expensive applicator acquisition and complex scheduling as challenging aspects of providing brachytherapy services. Conversely, respondents cite a dedicated team, departmental brachytherapy suite, well organized coordination of procedures and personnel, anesthesia support, a full range of applicators, image-based planning near the department and supportive administration as integral components in providing brachytherapy.</p><p><strong>Conclusions: </strong>Most surveyed institutions have >1 brachytherapist who perform 1-2 procedures per day in a dedicated brachytherapy space with a team that assists with coordination and scheduling efforts. A well supported multidisciplinary team is vital to ensure state of the art brachytherapy which is essential in curing these challenging malignancies.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control study of cervical cancer interstitial brachytherapy treatment plans using statistical process control.","authors":"Xiao Chen, Xiangxiang Shi, Huaiwen Zhang, Haowen Pang","doi":"10.1016/j.brachy.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>This study explored using statistical process control for quality control of cervical cancer interstitial brachytherapy treatment plans.</p><p><strong>Materials and methods: </strong>For retrospective analysis, interstitial brachytherapy treatment plans were divided into first (n = 300) and second phases (n = 200). The first phase was chronologically divided 2:1 into training and validation sets. The Dn2cm³ (D2cm³ divided by the high-risk clinical target volume D90) of the organs at risk (the bladder, rectum, and sigmoid colon) were analyzed to draw individual control charts. Process capability analysis charts were drawn, and the statistical process capability was evaluated using the process capability index C_pk. The centerline of the organ at risk dose in the first-phase plan's training set was used as the optimization parameter for the second-phase dataset plan.</p><p><strong>Results: </strong>The Dn2cm³ centerlines for the bladder, rectum, and sigmoid colon were 0.6980, 0.5440, and 0.4910 in the training set and 0.6845, 0.4528, and 0.4144 in the second phase, respectively. The first-phase δ values were 0.0099, 0.0530, and 0.0268, respectively. The process capability analysis for the first and second phases showed that all indicators had a C_pk >1.</p><p><strong>Conclusion: </strong>For all organs at risk, the Dn2cm³ centerlines were lower in the second phase than in the first phase, indicating that quality control of cervical cancer interstitial brachytherapy treatment plans continuously improved through statistical process control. This method is simple and practical and warrants promotion for application in radiotherapy treatment plan quality control.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed template assisted intracavitary/interstitial brachytherapy for cervical cancer using repeat FMEA: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.brachy.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.10.001","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Posters PO51","authors":"Nahuel Eduardo Paesano, Nuria Jornet i Sala, Jadi Rojas Cordero, Nahuel Paesano, Alicia Maccagno, Gilberto Chechile Toniolo","doi":"10.1016/j.brachy.2023.06.152","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.152","url":null,"abstract":"Purpose Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy. To evaluate oncological outcomes and genitourinary and gastrointestinal adverse events in patients treated with real-time low dose rate (LDR) Iodine-125 BT as a treatment for localized prostate cancer. Materials and Methods To carry out this study, all patients treated with BT in monotherapy with or without associated androgen deprivation therapy for the treatment of localized PCa were prospectively included from June 2003 to August 2021. Strict post-treatment follow-up was performed. was performed every 6 months. Reviews include quality of life (QoL) test, assessment of urinary obstructive symptoms using IPSS (International Prostate Examples Score), SHIM (Sexual Health Inventory for Men), IIEF-15 questionnaires to assess sexual quality, specific total stretching prostate (PSA), ultrasound and flowmetry. The statistical method used was the Kaplan Meier and Cox regression with the SPSS computer system. Results A total of 445 patients were evaluated. The mean age at which the BT was performed was 65.3 years (SD=7.7). The mean prostate volume was 41.0 cm3. (SD=14.3). The mean PSA before BT was 7.28 (SD= 4.33). Regarding the D'Amico risk classification, 48.3% (215/445) of the patients were low risk, 45.1% (201/445) intermediate risk, and 6.6% (29/445). 445) high risk. 22.5% (100/445) received associated hormonal therapy. 47.8% (213/445) of the patients presented urological complications after CT, with urinary frequency being the most frequent. Rectal complications manifested in 17.7% (78/445) of the patients and the most frequent was tenesmus. The main urinary complication was urinary frequency, which was significantly associated between the first 3 months and the year after CT. After one year, most patients had the same micturition quality as before BT. The mean follow-up is 6 years, showing an overall biochemical recurrence-free survival (BLFS) of 92.3% (411/445). Regarding biochemical recurrence according to risk group, 14 patients with treatment failure were low risk, 15 intermediate risk and 5 high risk. No statistically significant association was found between risk stratification and recurrence. However, for the group of patients considered to be at high risk, the percentage of recurrence was higher. Conclusions BT offers excellent oncological control in the treatment of low and intermediate risk prostate cancer with acceptable rates of adverse events. Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO126","authors":"Ron Digiaimo","doi":"10.1016/j.brachy.2023.06.226","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.226","url":null,"abstract":"This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers. This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers.","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO67","authors":"Tyler E. Gutschenritter, Anthony Pham, Homayon Parsai, Joe Bradlo, Merriah Montague, Sarah Reith, Justin Bell, Rosanna Mangibin, Richard Alex Hsi","doi":"10.1016/j.brachy.2023.06.168","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.168","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO38","authors":"Bethel Adefres, Christopher Jason Tien, Shari Damast","doi":"10.1016/j.brachy.2023.06.139","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.139","url":null,"abstract":"Purpose Adjuvant vaginal cuff brachytherapy (VCB) for endometrial cancer (EC) is typically delivered with single-channel vaginal cylinders with diameters ranging from 2.0 to 4.0 cm. Due to the unfavorable dosimetry of 2.0 cm diameter cylinders, larger diameter cylinders are used whenever possible. There are, however, occasional patients with narrow vaginal anatomy for whom only a 2.0 cm cylinder can be accommodated. In this unique population, in addition to the dosimetric challenges for a typical prescription to 5 mm depth (ie., heterogeneity of about 170% and 210% of prescription dose at the surface of the cylinder lateral walls and tip, respectively), there tend to be clinical challenges as well such as insertional pain or difficulty with procedural tolerance. This study reports the clinical outcomes of an EC cohort that received VCB with cylinder size 2.0 cm at a single institution. Materials and Methods From an IRB-approved institutional database of EC patients treated with VCB between 07/01/2014-11/30/2022, all patients that were fitted with 2.0 cm cylinder were retrospectively reviewed. Although our institutional prescriptions for cylinders larger than 2.0cm are at 5mm depth (6-7 Gy x 3 fractions weekly), for the 2.0cm cylinder patients, VCB prescriptions are to the vaginal surface (10Gy x 3 fractions weekly), to avoid issues resulting in unacceptably high surface dose. Patient demographics, disease and treatment characteristics, recurrence rates and complications were descriptively analyzed. Toxicity was recorded via the CTCAE v4.0. The Kaplan-Meier method was used to assess freedom from vaginal recurrence. All computations were performed in IBM SPSS Statistics 28. Results Among 655 consecutive EC patients treated with VCB, there were 36 women (5%) that were treated with cylinder size 2.0 cm. Median age was 68.5 years (range: 46-95 years). The majority were nulliparous (77.8%) and 15 women (42%) had documented baseline pain or anxiety related to pelvic examination prior to VCB. Median BMI was 39 (range: 19-62). Baseline vaginal length was 8.3cm (range: 5-14cm). 78% had stage I-II, 14% had stage IIIA, and 8% had stage IVB EC. The histological subtypes included endometrioid adenocarcinoma (69%), mixed (11%), serous (8%), clear cell (6%) and de-differentiated (6%). 42% of the patients received chemotherapy. None received external beam radiotherapy. Median interval from surgery to VCB was 54 days (range: 43-119 days). All received 10Gy x 3 fractions prescribed to vaginal surface, and active length was 3cm (5.6%), 4cm (63.9%) or 5cm (30.6%). 3D planning was performed in 58% of the cohort, while 2D planning was used in the remainder due to issues related to body habitus and/or poor mobility. Median follow-up was 17.5 months (range: 3-76 months). The 2-year freedom from vaginal recurrence was 96%. There was only 1 vaginal recurrence, which was out of field. 5 patients died from disease, unrelated to radiation treatment. There were no grade 2 or h","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO42","authors":"Ria Mulherkar, Hong Wang, Mark Jelenik, Hayeon Kim, Christopher J. Houser, Elangovan Doraisamy, Madeleine Courtney-Brooks, Alexander Olawaiye, John Comerci, Michelle Boisen, Jessica Berger, Joseph Kelley, Paniti Sukumvanich, Sarah Taylor, Robert Edwards, Lan Coffman, Ronald Buckanovich, Jamie Lesnock, Haider Mahdi, Shannon Rush, John Austin Vargo, Sushil Beriwal, Parul Barry","doi":"10.1016/j.brachy.2023.06.143","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.143","url":null,"abstract":"Disparities in race and socioeconomic factors affect patient access to cancer screening, treatment, and clinical outcomes. The aim of this project was to evaluate relationship between race and socioeconomic factors including insurance status, employment status, disability status, and distance from brachytherapy center on clinical outcomes including stage at presentation, number of nodes positive, brachytherapy technique, progression-free survival (PFS), and overall survival (OS). All cervical cancer patients treated with brachytherapy at our institution from 2007-2017 were identified. Race and socioeconomic factors including insurance status, employment status, disability status, and distance from brachytherapy center were recorded. Clinical characteristics including stage at presentation, number of involved nodes, and brachytherapy technique were also recorded. PFS and OS were calculated from date of last brachytherapy fraction, with censorship at date of last follow-up. Correlation was tested between racial and socioeconomic factors and survival outcomes (i.e., PFS and OS) using Cox regression models. Their association with other outcomes was examined with Wilcoxon rank sum tests, Fisher's exact tests, and Spearman's rank correlation coefficients where appropriate. 251 cervical cancer patients were identified, with median follow-up 5.2 years (IQR 2.0-7.7 years). On univariate analysis (UVA), there was no correlation between brachytherapy technique utilized, number of nodes positive, or stage at presentation and race, distance from treatment center, insurance status, employment status, or disability status. UVA did show a significant correlation between PFS and race, insurance status, employment status, and disability status. Significantly worse PFS was seen in non-white group (p=0.036), uninsured group (p<0.001), unemployed group (p<0.001), and disabled group (p=0.041). Similarly, there was significant correlation between OS and race, insurance status, employment status, and disability status. Significantly worse OS was seen in non-white group (p=0.005), uninsured group (p<0.001), unemployed group (p<0.001), and disabled group (p=0.008). On multivariate analysis (MVA), there was no significant correlation between race or disability status and PFS, but there was significantly improved PFS seen in patients with insurance (p < 0.001) and patients who were employed (p = 0.002). MVA showed no correlation between disability status and OS, but significantly worse OS in patients who were non-white (p=0.039) and significantly improved OS in patients with insurance (p<0.001), and patients who were employed (p-0.001). MVA showed no significant correlation between stage and insurance or employment status. MVA showed no significant correlation between histology and employment status; on MVA patients with government insurance were less likely to have squamous histology compared with no insurance (p=0.002). Insurance and employment status are significant pred","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}