KEY POINTS
- This retrospective single-centre study included 325 patients with locally advanced cervical cancer treated with curative-intent external beam radiotherapy and brachytherapy boost between 2005 and 2021.
- Median treatment completion time from external beam radiotherapy start to brachytherapy end was 52 days; 67% completed treatment within 56 days.
- In multivariable analysis, prolonged treatment time was independently associated with non-Hispanic ethnicity (odds ratio 3.74), performance status 1–4 (odds ratio 2.82), no insurance (odds ratio 3.26), para-aortic nodal coverage (odds ratio 2.33–2.87), and external beam radiotherapy at an outside institution (odds ratio 4.41).
- The simplified point score included ethnicity, performance status, smoking, insurance, incarceration history, para-aortic coverage, pre-treatment magnetic resonance imaging, and external beam radiotherapy location. The score-based model had an area under the curve of 0.759, similar to the full logistic model (0.765).
- Among patients with scores above 7, 53.6% experienced prolonged treatment, compared with 17.8% among those with scores 7 or below.
CLINICAL TAKEAWAY
This score may help brachytherapy centres identify patients who need early navigation, social work support, transport coordination, imaging coordination, insurance assistance, or smoking cessation support before treatment delays accumulate. It should not yet be used as a validated triage rule: the study was retrospective, had missing sociodemographic data, included only patients who ultimately completed brachytherapy at the centre, and requires external validation.