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Utilization of brachytherapy in Quebec, Canada

  • Magali Lecavalier-Barsoum
    Correspondence
    Corresponding Author. Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada, Tel.: 43-88-881927
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

    Department of Radiation Oncology, Jewish General Hospital, McGill, University, Montreal, Quebec, Canada
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  • Farzin Khosrow-Khavar
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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  • Krum Asiev
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

    Department of Medical Physics, Jewish General Hospital, McGill University, Montreal, Québec, Canada.
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  • Marija Popovic
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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  • Te Vuong
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

    Department of Radiation Oncology, Jewish General Hospital, McGill, University, Montreal, Quebec, Canada
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  • Shirin A. Enger
    Affiliations
    Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

    Department of Medical Physics, Jewish General Hospital, McGill University, Montreal, Québec, Canada.

    Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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      ABSTRACT

      BACKGROUND AND PURPOSE

      Despite the excellent clinical outcomes from brachytherapy treatments compared with other modalities and the low associated costs, there have been reports of a decline in utilization of brachytherapy. The aim of this study was to investigate in detail the trend in utilization of brachytherapy in the province of Québec, Canada, from 2011 to 2019.

      MATERIALS AND METHODS

      All radiotherapy clinics in the province of Quebec, and among these the clinics that provide brachytherapy treatments, were identified. This observational retrospective cohort study involved analysis of data compiled by the Ministère de la Santé et des Services Sociaux du Québec for the period of 2011 to end of 2019 on all brachytherapy procedures performed in the province of Quebec. Time series graphs were used to describe the number of high dose rate (HDR) and low dose rate (LDR) brachytherapy treatments during the studied time period. Statistical analysis was conducted using R statistical software.

      RESULTS

      Between 2011 and 2019, 12 hospitals in the province of Québec provided radiotherapy treatments, and all of them offered brachytherapy services. The median annual number of brachytherapy sessions was 4413 (range 3930-4829). HDR brachytherapy represented over 90% of all brachytherapy treatments throughout the study period. Significant changes over time were observed in the number of treatments: at least 5% change was seen only for the two most common subtypes of brachytherapy, HDR interstitial and HDR intracavitary, with an increase of 9.6% and a decrease of 9.2%, respectively. The use of other subtypes of brachytherapy (HDR-plesiotherapy, LDR-interstitial, LDR-intracavitary, LDR-eye plaque) was stable between 2011 and 2019, with ≤ 2.5% variation.

      CONCLUSION

      This study demonstrates an overall steady use of brachytherapy between 2011 and 2019 in Quebec. Brachytherapy offers numerous advantages for the treatment of diverse cancer sites. Although more sophisticated external beam radiotherapy treatments have emerged in the last decades, the precision and cost-effectiveness of brachytherapy remain unbeaten. To ensure the continued use and availability of brachytherapy, governments must put in place policies and regulations to that effect. Training and exposure of future health care professionals to brachytherapy within Quebec and Canada is essential to provide all patients the same access to this life saving modality.

      Keywords

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