Valakh Vladimir, Coopey Bryan C
Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, USA.
Cureus. 2019 Oct 21;11(10):e5951. doi: 10.7759/cureus.5951.
Introduction For women with intact cervical cancer treated by definitive chemoradiotherapy, the adverse impact of treatment prolongation is well-established. We aimed to identify potentially modifiable factors associated with the unwanted increase in the time required to complete the prescribed course of therapy. Methods We retrospectively examined treatment records of 104 consecutive cervical cancer patients receiving chemoradiation for cervical cancer, which included cervical high-dose-rate intracavitary brachytherapy performed at a single referral center. Association of factors, including distance to care, driving time, and income level with overall treatment time, was explored. Results Guideline-concordant treatment duration was achieved in 34% of cases. There was no significant correlation between treatment duration and any of the patient-related characteristics assessed in this study. Transitioning of the radiation oncology physician staffing at the brachytherapy center from a private practice non-integrated group to a large integrated group was associated with a decrease in mean overall treatment time, 61 vs. 68 days, p = 0.007. Conclusions We did not identify a modifiable patient-related factor amenable to a financial intervention. Administration of brachytherapy within an integrated system resulted in a shortened duration of the entire course of therapy for intact cervical cancer.
引言 对于接受根治性放化疗的宫颈癌未切除患者，治疗时间延长的不良影响已得到充分证实。我们旨在确定与完成规定疗程所需时间意外增加相关的潜在可改变因素。方法 我们回顾性检查了104例连续接受宫颈癌放化疗的患者的治疗记录，其中包括在单一转诊中心进行的宫颈高剂量率腔内近距离放疗。探讨了包括就医距离、驾车时间和收入水平等因素与总治疗时间的关联。结果 34%的病例达到了指南一致的治疗时长。本研究评估的治疗时长与任何患者相关特征之间均无显著相关性。近距离放疗中心的放射肿瘤学医师人员配置从私人执业非整合团队转变为大型整合团队与平均总治疗时间减少相关，分别为61天和68天，p = 0.007。结论 我们未确定适合进行财务干预的可改变的患者相关因素。在整合系统内进行近距离放疗可缩短完整宫颈癌整个疗程的时长。
