GSOR08 演讲时间：下午 5:35

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.054

Mayank Patel MD MBA , Samyukta Jhavar BS , Gaurav Gomber BS , Anne Hubbard MBA , Ann Klopp MD PhD , Andrew Farach MD , Michelle Ludwig MD MPH PhD

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引用次数: 0

摘要

目的近距离放射治疗是宫颈癌确诊治疗的重要组成部分。及时接受治疗可提高生存率。得克萨斯州是美国面积和人口第二大州。在此，我们探讨了该州近距离放射治疗（BT）中心的地理可用性。材料与方法我们查询了德克萨斯州癌症登记处 2010-2020 年间有关宫颈癌发病率和死亡率的公开数据。可用的 BT 中心由德克萨斯州卫生服务部 (DSHS) 辐射控制项目提供，并通过与各治疗机构直接联系进行核实。结果该州目前有 48 家机构在积极使用确定性串联&；环形/卵圆形腔内 BT 治疗宫颈癌。德克萨斯州卫生与社会服务部将全州按地理位置划分为 11 个公共卫生区域 (PHR)，以支持和协调全州的地方卫生需求。位于中南部地区的 PHR 8 的中心数量最少（1.23 个中心/1,000 个新病例），而位于北部地区的 PHR 1 的中心数量最多（8.73 个中心/1,000 个新病例）。得克萨斯州的总体发病率、死亡率和 BT 使用率分别为每 10 万人 9.4 例（美国为 7.7 例）、每 10 万人 2.8 例（美国为 2.6 例）和每 1,000 例新病例 3.43 例。在得克萨斯州，估计有 45% 的病例被诊断为局部晚期疾病。该州的总体局部晚期发病率为每 10 万人 4.2 例，比全国局部晚期发病率 2.7 例高出 55%。得克萨斯州每年有 31% 的宫颈癌患者死于宫颈癌，而全国仅有 10% 的患者死于宫颈癌。在县一级，亨德森县（Henderson County）的死亡率最高（每 10 万人中有 5.8 人死亡），而且没有 BT 可用。位于南部边境的伊达尔戈县（Hidalgo County）是发病率（500 例）和死亡率（157 例）最高的农村县。在没有任何 BT 中心的县中，本德堡县的绝对发病率（263 例）和死亡人数（90 例）最高。结论与全国的发病率相比，得克萨斯州的宫颈癌总体发病率和局部晚期宫颈癌的发病率都较高，这凸显了在全州普及 BT 服务的必要性。在此，我们回顾了宫颈癌的发病率、死亡率以及按县和公共卫生登记处划分的腔内 BT 中心的使用情况，以确定全州的 BT 荒漠。这项分析确定了高危人群以及改善 BT 获取途径的机会。目前，德克萨斯州各地都需要扩大优质 BT 中心和训练有素的手足口治疗师的地理覆盖范围。

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GSOR08 Presentation Time: 5:35 PM

Purpose

Brachytherapy is a critical component of definitive cervical cancer treatment. Timely access to treatment has shown an improved survival benefit. Texas is the second largest state by size and population in the US. Here we explore the geographic availability of brachytherapy (BT) centers in the state.

Materials and Methods

We queried publicly available data on cervical cancer incidence and mortality between 2010-2020 from the Texas Cancer Registry. Available BT centers were compiled from the Texas Department of State Health Services (DSHS) Radiation Control Program and verified by direct contact with each treating institution. Number of BT units per 1,000 new cases was calculated as an index of BT availability.

Results

The state currently has 48 institutions actively treating cervical cancer with definitive tandem & ring/ovoid intracavitary BT. Texas DSHS geographically divided the state into 11 public health regions (PHR) to support and coordinate the local health needs of the entire state. PHR 8 located in the south-central region has the lowest availability of centers (1.23 centers/1,000 new cases), while PHR 1 in the north region has the highest availability (8.73 centers/1,000 new cases). The overall Texas incidence rate, mortality rate, and BT availability is 9.4 per 100,000 (US rate 7.7), 2.8 per 100,000 (US rate 2.6), and 3.43 per 1,000 new cases, respectively. In Texas, it is estimated that 45% of cases are diagnosed with locally advanced disease. The overall state locally advanced incidence rate is 4.2 cases per 100,000 population, which is 55% higher than the national locally advanced incidence rate of 2.7. Annually, 31% of all cervical cancer patients diagnosed in Texas die from the disease, as compared to only 10% nationally. On the county level, Henderson County has the highest mortality rate (5.8 deaths per 100,000 population) and no BT availability. Hidalgo County located on the southern border has the highest incidence (500) and deaths (157) of rural counties. Fort Bend County has the highest absolute incidence (263) and deaths (90) for a county without any BT centers. Angelina County has the highest incidence rate (15.9 per 100,000) with a non-zero death rate (3.9 per 100,000).

Conclusions

Compared to national rates, Texas has a higher overall incidence rate of cervical cancer overall and locally advanced cervical cancer highlighting the need for widespread access to BT services across the state. Herein, we review cervical cancer incidence rates, mortality rates, and access to intracavitary BT centers by county and PHR to identify BT deserts across the state. This analysis identifies the highest at-risk populations and opportunities for improved BT access. There is an existing need for expanded geographic access to high-quality BT centers and well-trained brachytherapists across Texas.

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.