Ohio Heath Gynecologic Cancer Surgeons, Riverside Methodist Hospital, Medical Education, United States of America.
Ohio Heath Gynecologic Cancer Surgeons, Riverside Methodist Hospital, Medical Education, United States of America.
Gynecol Oncol. 2019 Mar;152(3):528-532. doi: 10.1016/j.ygyno.2018.09.011.
Completion of radiation therapy (RT) within 60 days has been proposed as a national quality measure for patients with carcinoma of the cervix as protracted RT has been associated with worse oncologic outcomes. The objective of this study was to compare compliance rates based on location of RT administration.
This was a retrospective chart review of patients diagnosed with cervical cancer between January of 2000 to December of 2016 who were planned to undergo primary treatment with sensitizing chemotherapy and RT. Patients who completed both external beam radiation therapy (EBRT) and brachytherapy (BT) at the primary institution were compared to patients who completed a portion or all of their RT elsewhere. The primary outcome measured was completion of RT within 60 days. Secondary outcomes included compliance with sensitizing chemotherapy, total radiation dose, recurrence rate, progression free survival (PFS) and overall survival (OS). The groups were compared using standard statistical analysis.
This study included 100 patients, 75 of which received all of their RT at the primary institution. These patients were more likely to complete RT within 60 days when compared to patients who underwent RT at different facilities (58.7% vs 24%, respectively; p = 0.005). Patients who underwent all of their RT at the primary institution completed their therapy an average of 16.4 days sooner (75.1 ± 21.3 days versus 58.7 ± 13.2 days; p = 0.001). Overall survival was significantly improved in this group (p = 0.03).
Women who complete EBRT and BT at different institutions are more likely to have a protracted RT course (>60 days). These patients should be identified at diagnosis and efforts made to coordinate their care to avoid delays in treatment.
已提出将放射治疗 (RT) 完成时间控制在 60 天内作为宫颈癌患者的国家质量指标，因为 RT 时间延长与较差的肿瘤学结果相关。本研究的目的是比较基于 RT 实施地点的依从率。
这是一项对 2000 年 1 月至 2016 年 12 月期间被诊断患有宫颈癌且计划接受增敏化疗和 RT 联合治疗的患者进行的回顾性图表审查。将在原发机构完成外照射放疗 (EBRT) 和近距离放疗 (BT) 的患者与在其他机构完成部分或全部 RT 的患者进行比较。主要观察指标为在 60 天内完成 RT。次要结果包括增敏化疗的依从性、总辐射剂量、复发率、无进展生存期 (PFS) 和总生存期 (OS)。采用标准统计学分析比较两组。
本研究共纳入 100 例患者，其中 75 例在原发机构接受了所有 RT。与在不同机构接受 RT 的患者相比，这些患者在 60 天内完成 RT 的可能性更高（分别为 58.7%和 24%；p=0.005）。在原发机构接受所有 RT 的患者完成治疗的平均时间早了 16.4 天（75.1±21.3 天比 58.7±13.2 天；p=0.001）。这组患者的总生存率显著提高（p=0.03）。
在不同机构完成 EBRT 和 BT 的女性更有可能出现 RT 时间延长 (>60 天)。应在诊断时识别这些患者，并努力协调他们的护理，以避免治疗延误。
