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  • [J Gynecol Oncol.] Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea

    [J Gynecol Oncol.] Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea

    국립암센터 / 김영애, 김연주*

  • 출처
    J Gynecol Oncol.
  • 등재일
    2021 Nov
  • 저널이슈번호
    32(6):e85. doi: 10.3802/jgo.2021.32.e85. Epub 2021 Jul 16.
  • 내용

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    Abstract
    Objective: External beam radiation therapy (EBRT) with concurrent chemotherapy followed by intracavitary brachytherapy is the standard treatment in locally advanced cervical cancer. This study examined the brachytherapy utilization rate and evaluated the effect of brachytherapy on survival in cervical cancer patients in Korea.

    Methods: In this study, data from the Korea Central Cancer Registry and Korean National Health Insurance Service and data on mortality from Statistics Korea were linked and used. Patients with other cancers, distant metastasis at diagnosis, or unknown stage or who underwent hysterectomy were excluded. A total of 12,721 cervical cancer patients were analyzed in this study.

    Results: The brachytherapy utilization rate (%) was calculated as the proportion of patients who received brachytherapy among those who received curative EBRT. The brachytherapy utilization rate decreased from 84% in 2005 to 78% in 2013 (p<0.001). Brachytherapy utilization rates varied by region, ranging from 72% to 100% except for in Jeju Island, where the rate was 56%. The brachytherapy utilization rate was lower in patients older than 80 years; patients with localized disease, non-squamous cell carcinoma, or Charlson comorbidity index 3 or more; patients diagnosed after 2010; patients from certain regions; patients receiving medical aid; and patients who underwent gynecologic procedures. Multivariable Cox regression analysis showed that brachytherapy when added to curative EBRT was independently associated with better cancer-specific survival (CSS) and overall survival (OS) than curative EBRT only.

    Conclusion: The brachytherapy utilization rate decreased from 2005 to 2013 and varied by region in Korea. Brachytherapy use is independently associated with significantly higher CSS and OS in cervical cancer

     

     

     

     

     

     

    Affiliations

    Young Ae Kim  1 , Min Soo Yang  1 , Minae Park  1 , Min Gee Choi  1 , So Young Kim  2 , Yeon-Joo Kim  3
    1 National Cancer Control Institute, National Cancer Center, Goyang, Korea.
    2 Health Insurance Research Institute, National Health Insurance Service, Wonju, Korea.
    3 Proton Therapy Center, National Cancer Center, Goyang, Korea. yjkim1785@ncc.re.kr.

  • 키워드
    Brachytherapy; Korea; Radiotherapy; Survival; Uterine Cervical Neoplasms.
  • 연구소개
    진행된 병기의 자궁경부암의 표준치료는 항암제와 함께 외부조사방사선치료(external beam radiation therapy, EBRT)를 시행한 후 근접치료(brachytherapy, BT)를 하는 것입니다. 자궁경부암의 근접치료는 자궁경부에 기구(applicator)를 삽입한 후 이 기구 안에 동위원소를 거치시켜 암에만 집중적으로 방사선을 조사하는 방법입니다. 2005년부터 2013년까지 우리나라 국민건강보험공단 자료를 이용하여 분석한 결과, 근접치료를 받지 않은 환자에 비해, 근접치료를 받은 환자에서 생존율이 월등히 높았습니다. 하지만, 안타깝게도 이 기간에 근접치료 이용률은 감소하였습니다. 근접치료는 의료인력 및 의료재원이 많이 소모되는 치료기법입니다. 보험수가 개선을 통해 근접치료 이용률을 올린다면, 자궁경부암 환자들의 생존율을 향상시킬 수 있을 것으로 생각됩니다.
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