Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA.
Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):e101-7. doi: 10.1016/j.ijrobp.2011.11.067. Epub 2012 Feb 16.
Intensity-modulated radiation therapy (IMRT) requires a high degree of expertise compared with standard radiation therapy (RT). We performed a retrospective cohort study of Medicare patients treated with IMRT compared with standard RT to assess outcomes in national practice.
Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, we identified patients treated with radiation for cancer of the head and neck from 2002 to 2005. We used multivariate Cox models to determine whether the receipt of IMRT was associated with differences in survival.
We identified 1613 patients, 33.7% of whom received IMRT. IMRT was not associated with differences in survival: the 3-year overall survival was 50.5% for IMRT vs. 49.6% for standard RT (p = 0.47). The 3-year cancer-specific survival was 60.0% for IMRT vs. 58.8% (p = 0.45).
Despite its complexity and resource intensive nature, IMRT use seems to be as safe as standard RT in national community practice, because the use of IMRT did not have an adverse impact on survival.
与标准放疗（RT）相比，调强放疗（IMRT）需要更高的专业水平。我们对接受 IMRT 治疗与接受标准 RT 治疗的 Medicare 患者进行了回顾性队列研究，以评估全国实践中的治疗效果。
我们使用国家癌症研究所的监测、流行病学和最终结果（SEER）-医疗保险链接数据库，确定了 2002 年至 2005 年期间接受放疗治疗头颈部癌症的患者。我们使用多变量 Cox 模型来确定接受 IMRT 是否与生存差异相关。
我们共确定了 1613 名患者，其中 33.7%的患者接受了 IMRT。IMRT 与生存差异无关：IMRT 的 3 年总生存率为 50.5%，标准 RT 为 49.6%（p=0.47）。IMRT 的 3 年癌症特异性生存率为 60.0%，标准 RT 为 58.8%（p=0.45）。
尽管 IMRT 复杂且资源密集，但在全国社区实践中，其使用似乎与标准 RT 一样安全，因为 IMRT 的使用并未对生存产生不利影响。
