Department of Radiation Oncology, Case Comprehensive Cancer Center and University Hospitals of Cleveland Case Medical Center, Cleveland, OH 44106, USA.
J Oncol. 2008;2008:931532. doi: 10.1155/2008/931532. Epub 2008 Aug 27.
Our study evaluated whether 1999 National Cancer Institute (NCI) chemoradiation guidelines for cervical cancer impacted treatment of women >/=55 years. We identified 385 women >/=55 years (median, 72 years) diagnosed with stage II-IVA cervical cancer between January, 1998 and December, 2002 in the United States Surveillance, Epidemiology, and End Results (SEER)-Medicare registries. Chemoradiation frequency tables were constructed for age, race, community setting, socioeconomic status, and comorbidity index. Of 385 women, 166 (43%) received chemoradiation as primary treatment. Prior to the 1999 NCI clinical alert, 5/43 (12%) in 1998 and 24/54 (44%) in 1999 received chemoradiation. The chemoradiation proportion was 41% (36/87) in 2000, 48% (51/107) in 2001, and 53% (50/94) in 2002 (trend, P < .01). Women >/=71 years had significantly lower odds of chemoradiation (P = .04). While SEER-Medicare data indicated an increasing trend for chemoradiation after the 1999 NCI clinical alert, chemoradiation was less frequent in elderly women with cervical cancer.
我们的研究评估了 1999 年美国国立癌症研究所（NCI）的宫颈癌放化疗指南是否影响了> = 55 岁女性的治疗。我们在美国监测、流行病学和最终结果（SEER）-医疗保险登记处中确定了 385 名> = 55 岁（中位数为 72 岁）患有 II-IVA 期宫颈癌的女性。根据年龄、种族、社区环境、社会经济地位和合并症指数构建了放化疗频率表。在 385 名女性中，166 名（43%）接受了放化疗作为主要治疗方法。在 1999 年 NCI 临床警报之前，1998 年有 5/43（12%），1999 年有 24/54（44%）接受了放化疗。2000 年放化疗比例为 41%（36/87），2001 年为 48%（51/107），2002 年为 53%（50/94）（趋势，P <.01）。> = 71 岁的女性接受放化疗的可能性显著降低（P =.04）。尽管 SEER-医疗保险数据表明，1999 年 NCI 临床警报后放化疗呈上升趋势，但老年宫颈癌女性的放化疗频率较低。
