Use of advanced treatment technologies among men at low risk of dying from prostate cancer.
Use of advanced treatment technologies among men at low risk of dying from prostate cancer.
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DOI：
10.1001/jama.2013.6882
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发表时间：
2013-06-26
影响因子：
120.7
通讯作者：
Hollenbeck, Brent K.
中科院分区：
文献类型：
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作者：
Jacobs, Bruce L.;Zhang, Yun;Schroeck, Florian R.;Skolarus, Ted A.;Wei, John T.;Montie, James E.;Gilbert, Scott M.;Strope, Seth A.;Dunn, Rodney L.;Miller, David C.;Hollenbeck, Brent K.
前列腺癌的先进治疗技术（即调强放疗[IMRT]和机器人直肠切除术）的使用正在增加。这些先进的治疗技术在前列腺癌死亡风险低的患者中传播的程度尚不确定。在前列腺癌死亡风险较低的男性中，评估先进治疗技术的使用情况，并与既往标准（即，传统外束放射治疗[EBRT]和开放性根治性前列腺切除术）和观察进行比较。使用监测、流行病学和最终结果（SEER）-医疗保险数据，我们确定了一个回顾性队列，这些男性在2004年至2009年间诊断为前列腺癌，接受了IMRT（n=23 633）、EBRT（n=3926）、机器人直肠癌切除术（n=5881）、开放性直肠癌根治术（n=6123）或观察（n=16 384）。随访数据截至2010年12月31日。在不太可能死于前列腺癌的男性中使用先进的治疗技术，根据低风险疾病（临床分期≤ T2 a，活检Gleason评分≤6，前列腺特异性抗原水平≤10 ng/mL），非癌症死亡率高风险（基于在没有癌症诊断的情况下10年内死亡的预测概率）或两者评估。在我们的队列中，先进治疗技术的使用从32%增加到20%。（95% CI，30%-33%）至44%（95% CI，43%-46%）在非癌症死亡率高风险的男性中，从36%（95% CI，35%-38%）到57%（95% CI，55%-59%）（P<.001）。在低风险疾病和高风险非癌症死亡率的男性中，这些先进治疗技术的使用从25%（95%CI，23%-28%）增加到34%（95%CI，31%-37%）（P<0.001）。在SEER中诊断的所有患者中，使用先进治疗技术治疗不太可能死于前列腺癌的男性的比例从13%增加到20%。（95% CI，12%-14%），或129.2/1000诊断为前列腺癌的患者，至24%（95% CI，24%-25%），或244.2/1000诊断为前列腺癌的患者（P<.001）。在2004年至2009年期间被诊断患有前列腺癌的男性中，低风险疾病，高风险非癌症死亡率或两者兼而有之，先进治疗技术的使用有所增加。
The use of advanced treatment technologies (ie, intensity-modulated radiotherapy [IMRT] and robotic prostatectomy) for prostate cancer is increasing. The extent to which these advanced treatment technologies have disseminated among patients at low risk of dying from prostate cancer is uncertain. To assess the use of advanced treatment technologies, compared with prior standards (ie, traditional external beam radiation treatment [EBRT] and open radical prostatectomy) and observation, among men with a low risk of dying from prostate cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified a retrospective cohort of men diagnosed with prostate cancer between 2004 and 2009 who underwent IMRT (n=23 633), EBRT (n=3926), robotic prostatectomy (n=5881), open radical prostatectomy (n=6123), or observation (n=16 384). Follow-up data were available through December 31, 2010. The use of advanced treatment technologies among men unlikely to die from prostate cancer, as assessed by low-risk disease (clinical stage ≤T2a, biopsy Gleason score ≤6, and prostate-specific antigen level ≤10 ng/mL), high risk of noncancer mortality (based on the predicted probability of death within 10 years in the absence of a cancer diagnosis), or both. In our cohort, the use of advanced treatment technologies increased from 32% (95% CI, 30%–33%) to 44% (95% CI, 43%–46%) among men with low-risk disease (P<.001) and from 36% (95% CI, 35%–38%) to 57% (95% CI, 55%–59%) among men with high risk of noncancer mortality (P<.001). The use of these advanced treatment technologies among men with both low-risk disease and high risk of noncancer mortality increased from 25% (95% CI, 23%–28%) to 34% (95% CI, 31%–37%) (P<.001). Among all patients diagnosed in SEER, the use of advanced treatment technologies for men unlikely to die from prostate cancer increased from 13% (95% CI, 12%–14%), or 129.2 per 1000 patients diagnosed with prostate cancer, to 24% (95% CI, 24%–25%), or 244.2 per 1000 patients diagnosed with prostate cancer (P<.001). Among men diagnosed with prostate cancer between 2004 and 2009 who had low-risk disease, high risk of noncancer mortality, or both, the use of advanced treatment technologies has increased.
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影响因子：
9.7
作者：
Jacobs, Bruce L.;Zhang, Yun;Hollenbeck, Brent K.
通讯作者：
Hollenbeck, Brent K.
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
23.4
作者：
Jacobs BL;Zhang Y;Skolarus TA;Wei JT;Montie JE;Miller DC;Hollenbeck BK
通讯作者：
Hollenbeck BK
DOI：
10.1158/1078-0432.ccr-12-1537
发表时间：
2012-12-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Etzioni R;Mucci L;Chen S;Johansson JE;Fall K;Adami HO
通讯作者：
Adami HO
影响因子：
6.2
作者：
Mell, LK;Mehrotra, AK;Mundt, AJ
通讯作者：
Mundt, AJ