Prostate brachytherapy case volumes by academic and non-academic practices: Implications for future residency training

Publication date: Available online 25 July 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Peter F. Orio, Paul L. Nguyen, Ivan Buzurovic, Daniel W. Cail, Yu-Wei Chen
PurposeThe utilization of prostate brachytherapy continues to decline in the United States. We examined the national practice patterns of both academic and non-academic practices performing prostate brachytherapy by case volume per year to further characterize the decline and postulate the impact this trend may have on training the next generation of residents.Methods and MaterialsMen diagnosed with prostate cancer and treated with radiation therapy in 2004-2012 were identified. Annual brachytherapy case volume at each facility was determined and further categorized into ≤12 cases per year (i.e. on average ≤1 case per month), 13-52 cases per year, and ≥53 cases per year (i.e. on average ≥1 case per week) in academic practices versus non-academic practices.ResultsIn 2004-2012, academic practices performing on average ≤1 brachytherapy case per month increased from 56.4% to 73.7% and this percentage increased from 60.2% to 77.4% in non-academic practices (P-value both<.0001). Practices performing on average ≥ 1 case per week decreased among both academic practices (from 6.7% to 1.5%) and non-academic practices (from 4.5% to 2.7%).ConclusionsBoth academic and non-academic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy from 2004-2012. As the case volume continues to decline it is unclear whether we are prepared to train the next generation of residents in this critical modality.

Teaser

With 73.7% of academic practices performing ≤12 brachytherapy implants per year, 24.8% performing 13-53 cases and only 1.5% performing ≥53 cases per year the question becomes the ability of academic training practices to adequately teach future residents to perform prostate brachytherapy. Given these concerning trends it must be determined how to fix this trend in order to ensure this treatment modality is not lost in the future.


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