Aims: To determine the trends in brachytherapy (BT) use in cervical cancer in Queensland, identify factors associated with treatment and to compare BT utilisation with optimal utilisation guidelines.
Methods: This retrospective population-based study used clinical and treatment data from linked data sources of Queensland Oncology Repository and the Qld Centre of Gynaecological Cancer Research data. The study population included Queensland (Qld) women with cervical cancer diagnosed between 2012-2021 (n=2,121) and the radiation therapy treatment patterns received, with a focus on brachytherapy treatment.
Results: Thirty five percent (n=736) of Qlders with cervical cancer received external beam radiation therapy (EBRT) and brachytherapy within 365 days of diagnosis, and 12% (260) women received EBRT only. Trends in EBRT and/or BT over the 10-year period have remained steady. Characteristics of women receiving BT include median age 55 years (range 22 to 87), more likely to reside in rural areas and have a disadvantaged socioeconomic status. FIGO stage was available for 78% of records and the distribution of stage for rural and urban women was similar with the majority of women (80%) presenting at an early stage (Stage I,II). For women with FIGO stage IB-IIA, 39% (213) received BT and for those with Stage IIB-IVA, 79% (377) received BT. The state-wide BT rate of 35% is less than the recommended optimal BT utilisation rate for cervical cancer of 49% (range 42% - 50%).
Conclusion: While the Qld BT utilisation rate is lower than the optimal BT rate, it is reassuring to find the trends in Qld remain steady. Reporting these outcomes allows comparisons with other jurisdictions and sets a baseline to enable prospective monitoring of BT utilisation for cervical cancer in Qld.