Introduction Brachytherapy, with external beam radiation, increases survival in the treatment of locally advanced cervical cancer (LACC). In 2016, Robin et al. reported only 44% of patients received standard-of-care (SOC) brachytherapy in the USA. The Pacific Island Health Care Project has provided humanitarian medical care to women from the U.S. Associated Pacific Islands (USAPI) for three decades at Tripler Army Medical Center (TAMC), a military health care system (MHS) facility. We evaluated whether this underserved and understudied patient population received SOC treatment for LACC at TAMC. Materials and Methods The TAMC tumor registry was searched for all cervical cancer cases from 1997 to 2019. Subjects were excluded if they did not have stage IB2-IVA disease and were not from USAPI. The primary outcome was the overall utilization of brachytherapy, and statistical analysis was performed using the chi-square test. Results We identified 214 women with cervical cancer treated at TAMC, of which 67 met the study criteria. Ninety-two percent had squamous cell carcinoma on histology. Of the patients identified, 48 (71.6%, P < .001) were treated with brachytherapy. Fifteen (22.4%) patients received external radiation alone, and four (6.0%) received chemoradiation without brachytherapy. A post-hoc power analysis was conducted with a power of 91.3%. Conclusions Women with cervical cancer from USAPI in the PIHCP program treated at TAMC received significantly higher rates of SOC radiation treatment than the U.S. population on average. This highlights the ability of PIHCP, through the MHS, to deliver SOC treatment for cervical cancer to an otherwise underserved patient population.

中文翻译：

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与美国平均人口相比，服务不足的患有局部晚期宫颈癌的太平洋岛民通过太平洋岛屿医疗保健项目和军事医疗保健系统接受更高比例的标准放射治疗

前言 近距离放射治疗采用外照射，可提高局部晚期宫颈癌 (LACC) 治疗的存活率。2016 年，罗宾等人。据报道，在美国只有 44% 的患者接受了标准护理 (SOC) 近距离放射治疗。三十年来，太平洋岛屿医疗保健项目一直在军事医疗保健系统 (MHS) 设施三重陆军医疗中心 (TAMC) 为来自美国相关太平洋岛屿 (USAPI) 的妇女提供人道主义医疗服务。我们评估了这个服务不足和研究不足的患者群体是否在 TAMC 接受了 LACC 的 SOC 治疗。材料和方法 在 TAMC 肿瘤登记处搜索了 1997 年至 2019 年的所有宫颈癌病例。如果受试者没有 IB2-IVA 期疾病且不是来自 USAPI，则被排除在外。主要结果是近距离放射治疗的总体利用率，并使用卡方检验进行统计分析。结果 我们确定了 214 名在 TAMC 接受治疗的宫颈癌女性，其中 67 名符合研究标准。92% 的患者在组织学上患有鳞状细胞癌。在确定的患者中，48 名 (71.6%, P < .001) 接受了近距离放射治疗。15 名 (22.4%) 患者仅接受外照射，4 名 (6.0%) 患者接受了没有近距离放疗的化放疗。事后功效分析以 91.3% 的功效进行。结论 PIHCP 计划中在 TAMC 治疗的 USAPI 宫颈癌女性接受的 SOC 放射治疗率明显高于美国人群的平均水平。这突出了 PIHCP 的能力，通过 MHS，