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Frequency of imaging procedures in the follow-up of testicular cancer patients in Israel

以色列睾丸癌患者随访中影像学检查的频率

基本信息

批准号：
276998111
负责人：
Professor Dr. Andreas Stang, since 3/2016
金额：
--
依托单位：
Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE)
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2015
资助国家：
德国
起止时间：
2014-12-31 至 2017-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/276998111?language=en
关键词：
Frequency imaging procedures follow up

项目摘要

Current evidence-based international guidelines on treatment of germ cell cancers have been increasingly recommended a postorchiectomy surveillance strategy including mostly computed tomography (CT) of abdomen for clinical stage I disease (roughly 60% of cases with testicular cancer) instead of applying traditional adjuvant therapy. Exposure to radiation resulting from diagnostic imaging procedures probably increases late cancer risk. The risks are of particular concern for younger patients. International guidelines vary widely regarding frequency and extent of CT imaging in the management of testicular cancers.Yet notably, despite concerns that even surveillance may have negative health consequences because of the radiation exposure from CT, to our knowledge only two population-based studies assessed the actual number of CT scans employed during follow-up care. In Canada, 97.8% of men in the cohort (N=2,569) had at least one CT scan of the abdomen-pelvis with a median of 10 scans (Interquartile range [IQR]: 4 to 18) within the first 5 years after diagnosis of testicular cancer. In a population-based study from Germany (N=139), 77.7% of men had at least one CT scan of the abdomen with a median of only 2 scans (IQR: 1 to 4) within a 3-year observation period after diagnosis.The aim of this study is to provide similar descriptive epidemiological measures of imaging procedures in the follow-up of testicular cancer patients in the different healthcare setting of Israel with higher resolution by histology, CS, prior treatment and CT scan details than preliminary studies. In contrast to preliminary works, the study will allow a head-to-head comparison of the number of CT examinations observed with the number recommended by guidelines. It is planned to utilize the computerized data of Maccabi Healthcare Services (MHS), the second largest, publicly funded, health maintenance organization in Israel. For the period 2003-2007, incident cases of testicular cancer among eligible MHS members will be obtained by direct linkage with the Israel National Cancer Registry. Data on diagnostic imaging procedures including CT and alternatives like magnetic resonance imaging of the chest, abdomen, pelvis and unspecified sites will be extracted during a 5-year period of follow-up for each individual patient. Risk models based on the Biological Effects of Ionizing Radiations VII Report and organ-specific radiation doses will be used to estimate the lifetime attributable risk of radiation induced cancer from CT examinations.

目前关于生殖细胞癌治疗的循证国际指南越来越多地推荐睾丸切除术后监测策略，包括临床I期疾病（约60%的睾丸癌病例）的腹部计算机断层扫描（CT），而不是应用传统的辅助治疗。暴露于诊断成像程序导致的辐射可能会增加晚期癌症的风险。这些风险对年轻患者尤其重要。关于CT成像在睾丸癌管理中的频率和程度，国际指南差异很大。然而，值得注意的是，尽管有人担心，由于CT的辐射暴露，即使是监测也可能对健康产生负面影响，但据我们所知，只有两项以人群为基础的研究评估了随访护理期间使用的CT扫描的实际数量。在加拿大，队列中97.8%的男性（N= 2，569）在诊断睾丸癌后的前5年内至少进行了一次盆腔CT扫描，中位数为10次扫描（四分位数间距[IQR]：4至18）。在一项来自德国的基于人群的研究中（N=139），77.7%的男性至少接受过一次腹部CT扫描，中位数仅为2次扫描（IQR：本研究的目的是提供类似的描述性流行病学措施的成像程序在以下-与初步研究相比，以色列不同医疗保健环境中的睾丸癌患者的组织学、CS、既往治疗和CT扫描细节的分辨率更高。与初步工作相比，该研究将允许对观察到的CT检查数量与指南建议的数量进行头对头比较。计划利用以色列第二大公共资助的保健组织马卡比保健服务的计算机化数据。在2003-2007年期间，将通过与以色列国家癌症登记处直接联系，获得符合条件的卫生部成员中的睾丸癌发病病例。将在5年随访期间提取每例患者的诊断性成像程序数据，包括胸部、腹部、骨盆和未指明部位的CT和替代方法（如磁共振成像）。将使用基于电离辐射生物效应第七号报告和器官特定辐射剂量的风险模型来估计CT检查中辐射诱发癌症的终生归因风险。