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Purpose: The health care industry has many stakeholders who seek relationships within government to ensure certain interests are considered in the legislative process. This study characterized the federal political contributions of US radiation oncologists (ROs).Methods and Materials: Public finance data from the Federal Election Commission (FEC) containing self-identified ROs' contributions to a federal candidate or committee were obtained from 2003 to 2018. Contribution recipients were classified as a political action committee (PAC) or a presidential, Senate, or House candidate. Political parties of recipients were based on FEC designations. For PACs, political parties of recipients were based on spending patterns to political parties in each 2-year election cycle or, when unavailable, overall spending patterns of greater than 50% to 1 political party, as detailed by the Center for Responsive Politics. Data were analyzed temporally, and Spearman's rho was used to assess trends.Results: From 2003 to 2018, the FEC reported a total of 31,646,000 federal political contributions. Exactly 4617 federal political contributions were made from 1021 unique self-identified ROs, totaling $3,350,747. The number of ROs making contributions ranged from 56 in 2005 to 600 in 2016 (mean, 289 ± 191.4 ROs yearly), with a mean annual contribution of $209,422. Of all RO dollars, 61.5% went to Democrats, 37.5% to Republicans, and 1.0% to third-party candidates. Most RO dollars (81.0%) went to PACs rather than candidates, with the majority of those PAC dollars (50.2%) directed toward the American Society for Radiation Oncology Political Action Committee. There was a positive annual trend in number of donors by year (ρ = 0.83, P < .0001) as well as RO contributions to the House (ρ = 0.58, P < .02), Senate (ρ = 0.58, P < .02), Democrats (ρ = 0.81, P < .001), Republicans (ρ = 0.66, P < .006), third-parties (ρ = 0.87, P < .001), PACs (ρ = 0.85, P < .0001), and overall (ρ = 0.8, P < .001). There was not a significant trend in contributions to presidential candidates (ρ = 0.71, P = .06).Conclusions: ROs' federal political contributions have significantly increased over the last decade and a half. This growth overwhelmingly represents contributions to specialty-focused PACs and both Democratic and Republican congressional candidates. [ABSTRACT FROM AUTHOR]

Purpose: To compare brachytherapy to external beam radiation therapy (EBRT) with respect to overall survival (OS) and disease-specific survival (DSS) among NSCLC patients undergoing limited surgical resection., Methods: All cases of T1-4 N0 M0 NSCLC undergoing limited resection and either brachytherapy or EBRT diagnosed between 2004 and 2014 were extracted from the Surveillance, Epidemiology, and End Results database. Chi-square test and Fisher's exact analysis were used to analyze categorical variables while Student's t-test was used to analyze continuous variables. Univariate analysis to assess for differences in survival with respect to covariates was performed with the log-rank test. Multivariable analysis was performed with Cox proportional hazards regression models among the entire cohort and after sub-stratification by T stage., Results: Among 543 patients, 471 underwent EBRT and 72 underwent brachytherapy. Brachytherapy demonstrated improved OS and DSS on univariate analysis as compared to EBRT (p < 0.05). Cox regression also demonstrated improved OS and DSS with brachytherapy (HR 0.604; 95% CI [0.380; 0.961] and HR 0.524; 95% CI [0.303; 0.908], respectively). Sub-cohort analysis demonstrated significant improvement in survival only among patients with T1 disease with similar survival between brachytherapy and EBRT among higher stage disease., Conclusions: Patients undergoing brachytherapy for T1-T4, N0, M0 NSCLC demonstrated at least similar survival as compared to those undergoing EBRT among patients undergoing limited resection. Improved survival was demonstrated among patients with T1 disease.

Purpose: To characterize inventions and assess trends in brachytherapy innovation based on brachytherapy-related patents awarded across the past 2 decades and provide insights that will help inform future research and entrepreneurship in the field., Methods: The United States Patent and Trademark Office database was searched for patents awarded between 1999 and 2018 with a classification code corresponding to the broadest brachytherapy search category. Patent characteristics were stratified and compared by geographic location, affiliation, and theme of invention., Results: There were 202 brachytherapy-related patents awarded from 2009 to 2018, which indicates a 56% increase in patent productivity and brachytherapy innovation compared with the previous decade from 1999 to 2008. Patents had an industry affiliation in 83% of cases from 1999 to 2008 and in 76% of cases from 2009 to 2018. Meanwhile, academic participation in brachytherapy patent innovation rose from 4% to 11% in that time. The focus and theme of inventions evolved across time, with radiation sources being the most common theme from 1999 to 2008 and falling to third place in 2009-2018. Conversely, development of brachytherapy-related patents involving exogenous agents such as drug-conjugates, radiosensitizers, and adjuncts to treatment increased substantially in the subsequent decade. While no collaboration was observed between academia and industry between 1999 and 2008, notable partnerships emerged in the subsequent decade which amounted to almost 5% of all patents awarded between 2009 and 2018., Conclusions: There has been an increase in overall brachytherapy patent production over time, and this has been accompanied by a greater variety of distinct patent themes. Collaboration between industry and academia is rare. Knowledge of brachytherapy patents may inform future research innovation in this field., (Copyright © 2020 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)

Purpose: To perform a retrospective analysis of the epidemiology and role of surgery on survival in patients with urethral clear cell carcinoma (UCCC) using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database., Methods: UCCC cases diagnosed from January 1, 1973, to December 31, 2014, were extracted from SEER. Descriptive statistics were calculated for all variables. Univariate analysis to assess for differences in survival with respect to covariates was performed using the log-rank test. Multivariate analysis was performed with Cox proportional hazards regression models to determine the predictive performance of covariates with respect to overall survival (OS) and disease-specific survival (DSS), reported as hazard ratio (HR) with 95% CIs. Comparisons were considered statistically significant at P < 0.05., Results: Sixty-one cases were extracted for analysis. Mean age ± SD was 63.0 ± 13.9 years. Fifty (82%), 18 (29.5%), and 14 (23.0%) patients underwent surgery, radiation, and chemotherapy, respectively. On univariate analysis, the following covariates were associated with both OS and DSS: age, stage, and surgery (all P < 0.001). On multivariate analysis, surgery was a predictor for improved OS and DSS (HR, 0.178; 95% CI [0.068; 0.464]) and HR, 0.166; 95% CI [0.057; 0.484], respectively). Neither radiation nor chemotherapy was significantly associated with OS or DSS., Conclusion: Surgery was associated with improved OS and DSS in patients with UCCC. While neither radiation nor chemotherapy was significantly associated with survival, additional studies are necessary to determine how these therapeutic interventions may impact prognosis.