近距离放射治疗 (BT) 是局部晚期宫颈癌患者治疗的一个组成部分，可显着改善局部控制和总体生存率。过去几十年来，美国 BT 的使用总体呈下降趋势，约 50% 的患者未接受 BT 治疗。利用率下降的原因是多因素的，包括医生的舒适度、设施容量、报销率低以及启动和维持近距离放射治疗计划的成本。这种下降与调强放射治疗 (IMRT) 和立体定向放射治疗 (SBRT) 等更新的先进技术的使用增加同时发生，导致肿瘤学结果较差和毒性增加。此外，美国广泛报道了 BT 使用方面的种族和社会经济差异。年龄、种族、社会经济地位、地点、设施类型、设施数量和保险状况等多种因素导致近距离放射治疗的机会有限，从而危及肿瘤治疗结果。这篇全面的评论讨论了美国的 BT 使用情况，研究了种族和社会经济因素对 BT 使用的影响，并强调了其对结果的影响。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Brachytherapy (BT) is an integral component of treatment for patients with locally advanced cervical cancer, significantly improving local control and overall survival. There is an overall trend of decreased utilization of BT in United States (US) in the last few decades with around 50% of patients being treated without BT. The cause of decreased utilization is multifactorial including physician comfort, facility volume, low reimbursements rates and costs of starting and maintaining a brachytherapy program. This decrease coincides with an increase in the use of newer advanced techniques like intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) boost resulting in inferior oncological outcomes and increased toxicity. Moreover, racial and socioeconomic disparities in BT utilization have been widely reported in the US. Various factors including age, race, socio-economic status, location, facility type, facility volume and insurance status result in limited access to brachytherapy, which jeopardizes oncologic outcomes. This comprehensive review discusses the BT utilization in the US, examines the impact of race and socioeconomic factors on BT utilization, and highlights its impact on outcomes.Copyright © 2023 Elsevier Inc. All rights reserved.