Enhancing Native American Participation in RT Trials

南达科他州拉皮特市的癌症护理研究所(CCI)为大约100,000名原住民提供服务 来自三个保留地的美国人。一些患者距离癌症中心的路程长达四个小时。 找出阻止美洲原住民出现早期癌症或 一些完全没有的情况，将被调查。一份对文化有反应的问卷将是 对保留地上随机选择的没有患癌症的美洲原住民进行管理。一个 第二份问卷将发放给癌症患者，并解决类似的问题，但集中在 其他与肿瘤学相关的问题。据推测，主要障碍是地理上的。 离家很近的文化/社区根源错位。传统的放射治疗需要6到8周 疗程和日常治疗。这种治疗方法可能是一个主要障碍。通过使用 调强放疗和近距离放射治疗等先进技术，治疗 病程可缩短至1至4周。因此，为了解决这个障碍，临床试验一直在进行 开发了缩短治疗时间的药物。一系列针对恶性肿瘤的二期研究被提出。 常见于美洲原住民：转移性疾病、非小细胞肺癌(NSCLC)、乳房、 前列腺癌和头颈部(H&N)癌。对于I期和II期乳腺癌患者，高剂量率 (HDR)近距离放射治疗将取代常规的外照射疗程。病人 晚期前列腺癌患者将接受为期2周的适形外照射治疗 放射治疗后植入HDR结合雄激素消融。试点放射治疗试验是 建议用于转移性疾病、局部晚期H&N和非小细胞肺癌患者。最终的飞行员试验将 研究单独使用HDR近距离放射治疗早期前列腺癌。一种遗传环境可能 这使得美洲原住民对辐射更加敏感。因此，将进行实验室研究 调查美洲原住民是否有更高的AT突变率 (共济失调-毛细血管扩张症)基因的测定通过外周血淋巴细胞。穿过 患者教育、筛查、评估医疗保健的潜在障碍和创新治疗 战略，希望美洲原住民最终将出现在他们的疾病过程中的更早。

The Cancer Care Institute (CCI) in Rapid City, South Dakota, serves approximately 100,000 Native Americans from three reservations. Some patients live up to four hours from the cancer center. Identifying barriers which prevent Native Americans from presenting with earlier stages of cancer, or in some circumstances not at all, will be investigated. A culturally responsive questionnaire will be administered to randomly selected Native Americans on the reservation who do not have cancer. A second questionnaire will be given to cancer patients, and address similar issues, but concentrate on additional questions of oncologic relevance. It is hypothesized that a major barrier is geographic dislocation from cultural/community roots close to home. Traditional radiotherapy involves a 6 to 8 week course and daily treatments. This treatment approach may represent a major barrier. With the use of advanced technologies such as intensity modulated radiotherapy and brachytherapy, the treatment course can be shortened to 1 to 4 weeks. Therefore, to address this barrier, clinical trials have been developed which shorten treatment duration. A series of phase II studies are proposed for malignancies commonly seen among the Native Americans: metastatic disease, non-small cell lung (NSCLC), breast, prostate and head and neck (H&N) cancer. For patients with stage I and II breast cancer, high-dose-rate (HDR) brachytherapy will be substituted for a conventional course of external beam radiation. Patients with advanced prostate cancer will be treated with a 2 week course of conformal external beam radiation followed by an HDR implant in combination with androgen ablation. Pilot tomotherapy trials are proposed for patients with metastatic disease, locally advanced H&N, and NSCLC. The final pilot trial will investigate the use of HDR brachytherapy alone for early stage prostate cancer. A genetic milieu may exist which renders Native Americans more sensitive to radiation. Therefore, a laboratory study will be conducted to investigate whether Native Americans have a higher mutation rate of the AT (ataxia-telangiectasia) gene determined through HPLC of the peripheral blood lymphocytes. Through patient education, screening, assessing potential barriers to health care, and innovative treatment strategies, it is hoped that Native Americans will eventually present earlier in their disease process.