Intensity-modulated radiation therapy use in the U.S, 2004
Intensity-modulated radiation therapy use in the U.S, 2004
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DOI：
10.1002/cncr.21284
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发表时间：
2005-09-15
期刊：
影响因子：
6.2
通讯作者：
Mundt, AJ
中科院分区：
文献类型：
--
作者：
Mell, LK;Mehrotra, AK;Mundt, AJ
背景资料。调强放射治疗(IMRT)是计划和实施放射治疗的一种新方法。尽管评估其风险和益处的数据有限，但美国放射肿瘤学家使用调强放射治疗的流行率似乎正在增加。方法：对美国放射肿瘤学家的随机抽样，包括2002年接受调查的441名内科医生，进行了关于调强放疗使用的调查。IMRT使用者被问及他们的使用频率、临床应用以及采用IMRT的原因。不使用IMRT的人被问及不使用IMRT的原因，他们是否计划在未来使用它，以及想要采用IMRT的原因。结果本次调查是在2004年7月1日至2004年8月31日之间进行的。在368名可评估的参与者中，239名医生(64.9%)做出了回应。使用调强放射治疗的受访者比例为73.2%(175名医生)，而2002年为32.0%。2002~2004年非使用者采用调强放疗的比例为62.7%(95%可信区间为51.9~73.5%)。许多(81.0%)调强放射治疗使用者(81.0%)使用调强放疗提供比常规剂量更高的辐射，主要是在泌尿生殖系统和头颈部肿瘤患者中。采用调强放射治疗的主要原因是允许正常组织保留(88.0%)、剂量增加(85.1%)和经济竞争(62.4%)。91%的非使用者计划在未来采用调强放射治疗。结论：自2002年以来，美国放射肿瘤学家中调强放射治疗的使用量显著增加。需要标准化的指导方针和评估其风险和收益的仔细的前瞻性分析。
BACKGROUND. intensity-modulated radiation therapy (IMRT) is a novel approach to the planning and delivery of radiation therapy. The prevalence of IMRT use among radiation oncologists in the U.S. appears to be increasing, despite limited data evaluating its risks and benefits.METHODS. A random sample of radiation oncologists in the U.S., including a cohort of 441 physicians who were surveyed in 2002, was surveyed regarding IMRT use. IMRT users were questioned regarding their frequency of use, clinical applications, and reasons for adopting IMRT. IMRT nonusers were asked their reasons for not using IMRT, whether they planned to use it in the future, and reasons for wanting to adopt IMRT. Differences in responses between 2002 and 2004 were compared.RESULTS. The survey was conducted between July 1, 2004 and August 31, 2004. Of 368 evaluable participants, 239 physicians (64.9%) responded. The proportion of respondents who used IMRT was 73.2% (175 physicians), compared with 32.0% in 2002. The adoption rate of IMRT among nonusers from 2002 to 2004 was 62.7% (95% confidence interval, 51.9-73.5%). Many IMRT users (81.0%) had used IMRT to deliver higher than conventional doses of radiation, predominantly in patients with genitourinary and head and neck tumors. Major reasons cited for IMRT adoption were permitting normal tissue sparing (88.0%), dose escalation (85.1%), and economic competition (62.4%). Ninety-one percent of nonusers planned to adopt IMRT in the future.CONCLUSIONS. IMRT use among radiation oncologists in the U.S. has increased significantly since 2002. Standardized guidelines and careful, prospective analyses evaluating its risks and benefits are needed.