Providing Patients with Locally Advanced Cervical Cancer Access to Brachytherapy: Experience from a Referral Network for Women Treated in Overseas France.
Providing Patients with Locally Advanced Cervical Cancer Access to Brachytherapy: Experience from a Referral Network for Women Treated in Overseas France.
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作者：
图像引导适应性近距离放射治疗（IGABT）在世界许多地区的可及性有限，从而导致治疗和护理的差异。我们回顾性研究的目的是报告在法国海外放疗机构和我们机构之间的妇女局部晚期宫颈癌（LACC）转诊网络的经验。这一系列的64例患者表明，对于需要IGABT的LACC女性患者，转诊过程的可行性，LC、无进展生存和总生存（OS）的估计概率分别为94.6% （95% CI: 88.9-100.0%）、72.7% （95% CI: 61.1-86.5%）和82.5% （95% CI: 72.0-94.5%）。然而，将这种先进技术集中到专家中心需要一个明确定义的工作流程和适当的资源规模，以最大限度地减少总体治疗时间。影像引导适应性近距离放射治疗（IGABT）是局部晚期宫颈癌（LACC）治疗标准的一部分。在许多地区，获得IGABT的机会有限，从而导致治疗和护理方面的差距。我们报告的经验转诊网络妇女与LACC之间的放疗设施在海外法国和古斯塔夫鲁西。这是一项回顾性研究，研究对象是2014年至2021年期间在法国海外接受初始放射治疗后接受脉冲剂量率（PDR）图像引导适应性BT治疗的Gustave Roussy LACC患者。64例患者符合接受IGABT的条件。总治疗时间（OTT）为60.5 d （IQR: 51 ~ 68.5）。中位随访时间为17个月。两年时，LC、无进展生存期和总生存期（OS）的估计概率分别为94.6% （95% CI: 88.9-100.0%）、72.7% （95% CI: 61.1-86.5%）和82.5% （95% CI: 72.0-94.5%）。在多变量分析中，对于较差的PFS （p = 0.001和p = 0.009）和较差的OS (p = 0.004和p = 0.004), D90CTVHR < 85GyEQD2和CTVHR容积> 40 cm3具有显著性意义。将这种先进技术集中到专家中心需要一个明确定义的工作流程和适当的资源维度，以最大限度地减少OTT。
Access to image-guided adaptive brachytherapy (IGABT) is limited in many regions in the world, thus leading to treatment care disparities. The aim of our retrospective study was to report the experience of a referral network for women with locally advanced cervical cancer (LACC) between radiotherapy facilities in Overseas France and our institution. This series of 64 patients shows the feasibility of a referral process for women with LACC who require IGABT with estimated probabilities of LC, progression-free survival, and overall survival (OS) of 94.6% (95% CI: 88.9–100.0%), 72.7% (95% CI: 61.1–86.5%), and 82.5% (95% CI: 72.0–94.5%). However, the centralization of this advanced technique to expert centers requires a well-defined workflow and appropriate dimensioning of resources to minimize overall treatment time. Image-guided adaptive brachytherapy (IGABT) is part of the standard of care for locally advanced cervical cancer (LACC). Access to IGABT is limited in many regions, thus leading to treatment care disparities. We report the experience of a referral network for women with LACC between radiotherapy facilities in Overseas France and Gustave Roussy. This is a retrospective review of patients with LACC referred to Gustave Roussy, for pulsed-dose-rate (PDR) image-guided adaptive BT after initial radiation therapy in the French overseas between 2014 and 2021. Sixty-four patients were eligible to receive IGABT. Overall treatment time (OTT) was 60.5 days (IQR: 51–68.5). The median follow-up time was 17 months. At two years, estimated probabilities of LC, progression-free survival, and overall survival (OS) were 94.6% (95% CI: 88.9–100.0%), 72.7% (95% CI: 61.1–86.5%), and 82.5% (95% CI: 72.0–94.5%). In multivariable analysis, a D90CTVHR < 85GyEQD2 and a CTVHR volume > 40 cm3 were significant for poorer PFS (p = 0.001 and p = 0.009, respectively) and poorer OS (p = 0.004 and p = 0.004). The centralization of this advanced technique to expert centers requires a well-defined workflow and appropriate dimensioning of resources to minimize OTT.
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影响因子：
3.3
作者：
Lichter, Katie;Akinfenwa, Chidinma Anakwenze;MacDuffie, Emily;Bhatia, Rohini;Small, Christina;Croke, Jennifer;Small, William;Chino, Junzo;Petereit, Daniel;Grover, Surbhi
通讯作者：
Grover, Surbhi
影响因子：
1.9
作者：
Chargari, Cyrus;Mazeron, Renaud;Haie-Meder, Christine
通讯作者：
Haie-Meder, Christine
影响因子：
34.3
作者：
Arbyn, Marc;Weiderpass, Elisabete;Bray, Freddie
通讯作者：
Bray, Freddie
DOI：
10.1016/0360-3016(95)00220-s
发表时间：
1995-07-30
影响因子：
7
作者：
PEREZ, CA;GRIGSBY, PW;LOCKETT, MA
通讯作者：
LOCKETT, MA
影响因子：
3.1
作者：
Majercakova, Katarina;Poetter, Richard;Schmid, Maximilian P.
通讯作者：
Schmid, Maximilian P.