Uptake and outcomes of intensity-modulated radiation therapy for uterine cancer.
Uptake and outcomes of intensity-modulated radiation therapy for uterine cancer.
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DOI：
10.1016/j.ygyno.2013.03.006
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发表时间：
2013-07
影响因子：
4.7
通讯作者：
Hershman DL
中科院分区：
文献类型：
--
作者：
Wright JD;Deutsch I;Wilde ET;Ananth CV;Neugut AI;Lewin SN;Siddiq Z;Herzog TJ;Hershman DL
虽然调强放射治疗（IMRT）允许更精确的放射计划，但该技术比适形放射昂贵得多，而且迄今为止，IMRT对子宫癌的益处还没有得到很好的定义。我们研究了调强放射治疗的使用及其对子宫癌晚期毒性的影响。对2001-2007年接受治疗并在SEER-Medicare数据库中登记的子宫癌妇女进行了检查。我们调查了调强放射治疗的范围和预测因素。急性和晚期放射毒性的发生率进行了比较IMRT和适形放射。我们共确定了3555例患者，其中328例（9.2%）接受了调强放疗。调强放射治疗的使用率从2001年的1.5%上升到2007年的23.2%。在多变量模型中，居住在美国西部和接受化疗与接受调强放疗相关。接受调强放疗的女性肠梗阻发生率较高（率比=1.41; 95%CI，1.03-1.93），但其他晚期胃肠道和泌尿生殖系统毒性以及髋部骨折发生率在两个队列之间相似。在考虑其他特征后，IMRT的成本比适形放射高14，706美元（95% CI，12，073美元至17，339美元）。IMRT在子宫癌治疗中的应用正在迅速增加。调强放射治疗与放射毒性的降低无关，但成本更高。
While intensity-modulated radiation therapy (IMRT) allows more precise radiation planning, the technology is substantially more costly than conformal radiation and, to date, the benefits of IMRT for uterine cancer are not well defined. We examined the use of IMRT and its effect on late toxicity for uterine cancer. Women with uterine cancer treated from 2001-2007 and registered in the SEER-Medicare database were examined. We investigated the extent and predictors of IMRT administration. The incidence of acute and late-radiation toxicities were compared for IMRT and conformal radiation. We identified a total of 3555 patients including 328 (9.2%) who received IMRT. Use of IMRT increased from 1.5% in 2001 to 23.2% in 2007. In a multivariable model, residence in the western U.S. and receipt of chemotherapy were associated with receipt of IMRT. Women who received IMRT had a higher rate of bowel obstruction (rate ratio=1.41; 95% CI, 1.03-1.93), but other late gastrointestinal and genitourinary toxicities as well as hip fracture rates were similar between the cohorts. After accounting for other characteristics, the cost of IMRT was $14,706 (95% CI, $12,073 to $17,339) greater than conformal radiation. Use of IMRT for uterine cancer is increasing rapidly. IMRT was not associated with a reduction in radiation toxicity, but was more costly.
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DOI：
10.1016/j.ijrobp.2004.12.029
发表时间：
2005-07-15
影响因子：
7
作者：
Ahamad, A;D'Souza, W;Eifel, PJ
通讯作者：
Eifel, PJ
影响因子：
4.7
作者：
Secord, Angeles Alvarez;Havrilesky, Laura J.;Gehrig, Paola A.
通讯作者：
Gehrig, Paola A.
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
4.7
作者：
Homesley, Howard D.;Filiaci, Virginia;Gibbons, Susan K.;Long, Harry J.;Cella, David;Spirtos, Nick M.;Morris, Robert T.;DeGeest, Koen;Lee, Roger;Montag, Anthony
通讯作者：
Montag, Anthony
影响因子：
168.9
作者：
Blake, P.;Swart, Ann Marie;Orton, J.;Kitchener, H.;Whelan, T.;Lukka, H.;Eisenhauer, E.;Bacon, M.;Tu, D.;Parmar, M. K. B.;Amos, C.;Murray, C.;Qian, W.
通讯作者：
Qian, W.