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Timely delivery of primary chemoradiation for the treatment of locally advanced cervical cancer: are we meeting this quality measure?

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

Treatment time has been used as a benchmark of quality care for women receiving primary concurrent chemoradiation (CCRT) for locally advanced cervical cancer. We assessed adherence to this quality measure and the impact of delays in therapy on clinical outcomes.

Methods

This retrospective review included patients treated with CCRT for cervical cancer between January 2000 and June 2014. Primary outcome was adherence to the quality measure of completion of therapy ≤56 days. Secondary outcomes include treatment times, response, recurrence, progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS).

Results

Of the 201 patients included, 90 (44.8%) completed therapy ≤56 days. There were no differences in baseline characteristics for patients completing therapy in ≤56 days versus >56 days. External beam radiation therapy (EBRT) at a local/non-academic facility, prolonged time to complete EBRT, and longer time to initiation of brachytherapy (BT) were associated with total treatment time prolongation. No significant differences in response, recurrence, PFS, DSS, or OS were observed with respect to total treatment time; however, protracted time to complete EBRT was associated with decreased PFS and DSS.

Conclusions

More than 50% of patients treated with primary CCRT for locally advanced cervical cancer fail to meet the quality benchmark for timely completion of therapy. Location of treatment, time to completion of EBRT, and delay in initiation of BT was associated with treatment prolongation. Though total treatment time failed to correlate with disease-specific outcomes, treatment delays during EBRT were detrimental to PFS and DSS.

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Authors and Affiliations

  1. Division of Gynecologic Oncology , Arthur G. James Cancer Hospital and Richard J Solove Research Institute, The Ohio State University Comprehensive Cancer Center, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH, 43210, USA

    Kristin Bixel & Ritu Salani

  2. Cedars- Sinai, Department of Obstetrics and Gynecology, Los Angeles, CA, USA

    Leah Marsh

  3. Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA

    Nathan Denlinger

  4. Department of Hematology Oncology, Arthur G. James Cancer Hospital and Richard J Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    John L Hays

  5. Department of Radiation Oncology, Arthur G. James Cancer Hospital and Richard J Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    Allison Quick

Authors
  1. Kristin Bixel
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  2. Leah Marsh
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  3. Nathan Denlinger
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  4. John L Hays
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  5. Allison Quick
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  6. Ritu Salani
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Corresponding author

Correspondence to Kristin Bixel.

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No funding was provided for this work.

Conflict of interest

Kristin Bixel has no conflicts of interest to disclose. Leah Marsh has no conflicts of interest to disclose. Nathan Denlinger has no conflicts of interest to disclose. John L Hays has no conflicts of interest to disclose. Allison Quick has no conflicts of interest to disclose. Ritu Salani has no conflicts of interest to disclose.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Bixel, K., Marsh, L., Denlinger, N. et al. Timely delivery of primary chemoradiation for the treatment of locally advanced cervical cancer: are we meeting this quality measure?. J Radiat Oncol 6, 189–195 (2017). https://doi.org/10.1007/s13566-017-0311-x

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  • DOI: https://doi.org/10.1007/s13566-017-0311-x

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