Enhancing Native American Participation in RT Trials

位于南达科他州拉皮德城的癌症护理研究所（CCI）为大约100，000名原住民提供服务。 三个保留地的美国人。有些病人住在离癌症中心四个小时的地方。 确定阻止美洲原住民出现早期癌症的障碍，或 有些情况根本就不是，会被调查的。一份文化回应问卷将 在保留地随机选择没有癌症的美洲原住民。一 第二份问卷将发给癌症患者，并解决类似的问题，但重点是 肿瘤学相关的其他问题。据推测，一个主要的障碍是地理上的 远离家乡附近的文化/社区根源。传统的放射治疗需要6到8周的时间 疗程和日常治疗。这种治疗方法可能是一个主要障碍。与使用 先进的技术，如调强放射治疗和近距离放射治疗，治疗 课程可缩短至1至4周。因此，为了解决这一障碍， 缩短了治疗时间。一系列II期研究拟用于恶性肿瘤 常见于美洲原住民：转移性疾病，非小细胞肺（NSCLC），乳腺癌， 前列腺癌和头颈癌（H&N）。对于I期和II期乳腺癌患者， (HDR)近距离放射治疗将取代常规的外部射束放射过程。患者 晚期前列腺癌患者将接受为期2周的适形外照射治疗， 放疗后进行HDR植入并结合雄激素消融。先导断层治疗试验是 建议用于转移性疾病、局部晚期H&N和NSCLC患者。最后的试点试验将 研究单独使用HDR近距离放射治疗早期前列腺癌。遗传环境可能 这使得美国原住民对辐射更加敏感。因此，将进行实验室研究， 进行了一项研究，以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）基因通过外周血淋巴细胞的HPLC测定。通过 患者教育、筛查、评估医疗保健的潜在障碍和创新治疗 因此，我们希望美洲原住民最终能在疾病过程中更早出现。

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.