Faculty Collaboration Database

Patterns of radiation therapy practice for patients treated for intact cervical cancer in 2005 to 2007: a quality research in radiation oncology study. Int J Radiat Oncol Biol Phys 2014 Jun 01;89(2):249-56

Date

01/15/2014

Pubmed ID

24411621

DOI

10.1016/j.ijrobp.2013.11.228

Scopus ID

2-s2.0-84899933996 (requires institutional sign-in at Scopus site)   81 Citations

Abstract

PURPOSE: To assess practice patterns and compliance with clinical performance measures for radiation therapy (RT) for patients with intact carcinoma of the cervix.

METHODS AND MATERIALS: Trained research associates reviewed the records of 261 randomly selected patients who received RT for cervix carcinoma between 2005 and 2007 from 45 facilities randomly selected after stratification by practice type. National estimates of patient and treatment characteristics were calculated from survey data using SUDAAN statistical software.

RESULTS: From the survey data, we estimated that only 8% of US facilities treated on average more than 3 eligible patients per year. No small or medium nonacademic facilities in the survey treated more than 3 eligible patients per year. Approximately 65.5% of patients began treatment in a facility that treated 3 or fewer eligible patients per year. Although 87.5% of patients had brachytherapy as part of their treatment, the proportion treated with external beam RT only was about double that estimated from the 1996 to 1999 survey. The use of high-dose-rate brachytherapy sharply increased, particularly in small nonacademic facilities. Overall, patients treated in nonacademic facilities were more likely to have incomplete or protracted treatment; 43% of patients treated in small nonacademic facilities did not have treatment completed within 10 weeks. Also, patients treated in facilities that treated 3 or fewer eligible patients per year were significantly less likely to receive concurrent chemotherapy than were patients treated in other facilities.

CONCLUSION: Survey results indicate a disturbingly high rate of noncompliance with established criteria for high-quality care of patients with cervical cancer. Noncompliance rates are particularly high in nonacademic facilities, especially those that treat relatively few patients with intact cervical cancer.

Author List

Eifel PJ, Ho A, Khalid N, Erickson B, Owen J

Author

Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Brachytherapy
Cancer Care Facilities
Female
Guideline Adherence
Health Care Surveys
Health Facility Size
Humans
Middle Aged
Radiation Oncology
Radiotherapy Dosage
Uterine Cervical Neoplasms