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Estimation of an optimal radiotherapy utilization rate for gynecologic carcinoma†
Part I–Malignancies of the cervix, ovary, vagina, and vulva
Version of Record online: 12 JUL 2004
Copyright © 2004 American Cancer Society
Volume 101, Issue 4, pages 671–681, 15 August 2004
How to Cite
Delaney, G., Jacob, S. and Barton, M. (2004), Estimation of an optimal radiotherapy utilization rate for gynecologic carcinoma. Cancer, 101: 671–681. doi: 10.1002/cncr.20444
See also pages 682–92, this issue.
- Issue online: 2 AUG 2004
- Version of Record online: 12 JUL 2004
- Manuscript Accepted: 18 MAY 2004
- Manuscript Received: 13 APR 2004
- Australian Commonwealth Department of Health and Ageing
- radiotherapy utilization;
- cervical carcinoma;
- ovarian carcinoma;
- vulvar carcinoma;
- vaginal carcinoma
Radiotherapy usage rates exhibit wide variations both within and between countries. Current estimates of the proportion of cancer patients who should optimally receive radiotherapy are based either on expert opinion or on the measurement of actual usage rates rather than on the best available scientific evidence.
With the goal of developing an evidence-based benchmark for radiotherapy use in the treatment of malignancies of the cervix, vagina, vulva, and ovary (endometrial malignancies are covered in a separate article), the authors reviewed international evidence-based treatment guidelines. Optimal radiotherapy usage trees were constructed, and proportions of patients with clinical indications for radiotherapy were obtained from epidemiologic data. These ideal usage rates were compared with actual radiotherapy utilization rates recorded in Australia and elsewhere.
According to the best available evidence, radiotherapy is indicated at least once for 58% of patients with cervical carcinoma, 4% of patients with ovarian carcinoma, 100% of patients with vaginal carcinoma, and 34% of patients with vulvar carcinoma. A review of the limited data available suggests that actual radiotherapy usage rates for patients with gynecologic malignancies are comparable to optimal usage rates.
Actual practice appears to approximate the authors' model of optimal radiotherapy use. This finding reflects the high level of agreement among treatment guidelines as well as the existence of high-quality evidence related to the management of gynecologic malignancies, and it may also be indicative of the fact that a large proportion of patients are treated in specialist units. The management of gynecologic malignancies may serve as a good example in the development of management strategies for other types of cancer. Cancer 2004. © 2004 American Cancer Society.