Scdt-47. National Patterns and Outcomes of Initial Interstitial Brachytherapy for Cns Neoplasms
Year: 2017
Type: conference-abstract
Abstract: Despite increasing therapeutic promise and advances, the national patterns of interstitial brachytherapy remain unknown. The US National Cancer Database, comprising ~70% of all newly-diagnosed cancers, was analyzed for brachytherapy-treated CNS neoplasms (2004-2014). 325 patients with newly-diagnosed primary CNS neoplasms underwent brachytherapy (i.e. interstitial, intracavitary, or intravascular radiotherapy) as part of their initial treatment. 77 (24%) were exclusively encoded as interstitial (results reported below), compared to 21% as intracavitary, 27% as I131/P32 radioisotopes, and 29% brachytherapy NOS. Median age at diagnosis was 61yo (IQR:50-72), with 51% male patients. 54% were treated at comprehensive cancer programs and 30% at academic programs; predominantly in New England (37%). Insurance was commonly private (55%) and Medicare (35%). The predominant tumor types were glioma (77%, 53/59 were GBM) and meningioma (12%). Patients underwent interstitial brachytherapy a median of 14d after diagnosis (IQR: 4-35). 61% of cases employed a high-rate radioisotope source. Patients additionally underwent chemotherapy (50%) and beam radiotherapy (30%), as indicated. Only 77% of patients were encoded as having surgery, 45% in which the definitive surgery included intraoperative interstitial radiotherapy-only 1 of which experienced a (unplanned) readmission within 30d, and 98% were alive at 30d. Despite the increasing interest in interstitial therapies, national registry standards have not been updated to appropriately capture these treatments. The NAACCR (sponsored by NCI/CDC/AJCC/ACS), which sets state/national cancer registration standards and forms the basis for national datasets like SEER and NCDB, presently doesn’t incorporate information on chemo/immunotherapy or I131/P32 delivery modality, only encodes surgical EOR, and lacks brachytherapy radiodosage/parameters. Nevertheless, our limited national sample supports the 30d safety of interstitial brachytherapy in the initial treatment of CNS neoplasms. It’s crucial for the interstitial therapeutics community to continue working with registry and billing standards agencies to ensure the appropriate integration of these exciting modalities into common practice.
Source: Neuro-Oncology
Authors: Bryan Iorgulescu, Saksham Gupta, Cheryl Zogg, Tim Smith
Institutions: Brigham and Women's Hospital, Harvard University
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2767418268