1. Stereotactic Body Radiation Therapy, Intensity-Modulated Radiation Therapy, and Brachytherapy Boost Modalities in Invasive Cervical Cancer: A Study of the National Cancer Data Base.
- Author
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OʼDonnell B, Shiao JC, Pezzi TA, Waheed N, Sharma S, Bonnen MD, and Ludwig MS
- Subjects
- Adult, Aged, Aged, 80 and over, Brachytherapy methods, Databases, Factual, Female, Humans, Logistic Models, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Propensity Score, Radiosurgery methods, Radiotherapy, Intensity-Modulated methods, Survival Analysis, Treatment Outcome, United States epidemiology, Uterine Cervical Neoplasms pathology, Young Adult, Brachytherapy statistics & numerical data, Radiosurgery statistics & numerical data, Radiotherapy, Intensity-Modulated statistics & numerical data, Uterine Cervical Neoplasms mortality, Uterine Cervical Neoplasms radiotherapy
- Abstract
Background and Purpose: Our objective was to determine whether stereotactic body radiotherapy (SBRT), intensity-modulated radiation therapy (IMRT), and brachytherapy boost techniques have comparable overall survival in treating cervical cancer when adjusted for known prognostic factors., Materials and Methods: We used the National Cancer Database to study women with invasive cervical cancer who were treated with radiation between 2004 and 2013. A logistic regression model was built to identify factors associated with the receipt of SBRT and IMRT. Outcomes were compared using Kaplan-Meier and propensity score matching., Results: Of all 15,905 patients, 14,394 (90.5%) received brachytherapy, 42 (0.8%) received SBRT, and 1468 (9.2%) received IMRT. After propensity score matching, there was no significant difference in overall survival (OS) for patients who received SBRT boost versus brachytherapy boost (hazard ratio = 1.477, 95% confidence interval = 0.746-2.926, P = 0.263) but a significant OS detriment in patients who received IMRT boost versus brachytherapy boost (hazard ratio = 1.455, 95% confidence interval = 1.300-1.628, P < 0.001)., Conclusions: In a propensity-matched analysis, those who received SBRT boost had equal OS when compared with brachytherapy, but those who received IMRT boost had worse OS when compared with brachytherapy.
- Published
- 2018
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