Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.
Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C.
Anticancer Res. 2014 Sep;34(9):5175-80.
To compare the effectiveness of intensity-modulated radiotherapy (IMRT) vs. 3D conformal radiotherapy (3DCRT) for clinical stage III non-small cell lung cancer (NSCLC) treated with primary chemoradiotherapy via a population-based retrospective cohort analysis.
Using the Collaboration Center of Health Information Application (CCHIA) database, we identified 99 patients with stage III NSCLC treated with primary chemoradiotherapy from 2007 to 2009, with complete data available for analysis. We compared the risk of death within two years of diagnosis and the hazard ratio for death between those treated with IMRT and those with 3DCRT. Univariate and multivariate analyses were conducted to determine the efficacy of IMRT and 3DCRT. Sensitivity analyses were also conducted to assess relationships in the various subgroups.
The risk of death within two years of diagnosis was similar for IMRT and 3DCRT (36% vs. 37%, p=0.97). For the entire follow-up period, the probability of death was not statistically different when IMRT was compared to 3DCRT (p=0.8). On multivariate analysis, the adjusted hazard ratio of death was statistically insignificantly higher for IMRT vs. 3DCRT (hazard ratio of death=1.54, 95% confidence interval=0.82-2.91, p=0.18). The results remained similar in the sensitivity analyses.
Our population-based analysis from CCHIA suggests that for patients with clinical stage III NSCLC treated with primary chemoradiotherapy, the survival outcome of those treated with IMRT was not superior to those treated with 3DCRT. Further prospective studies and cost-effectiveness analyses are warranted.
通过基于人群的回顾性队列分析，比较调强放疗（IMRT）与三维适形放疗（3DCRT）在原发性放化疗治疗的Ⅲ期非小细胞肺癌（NSCLC）中的疗效。
利用协作中心卫生信息应用（CCHIA）数据库，我们从 2007 年至 2009 年确定了 99 例接受原发性放化疗的Ⅲ期 NSCLC 患者，有完整的数据可供分析。我们比较了接受 IMRT 和 3DCRT 治疗的患者在诊断后两年内死亡的风险和死亡的风险比。进行单变量和多变量分析以确定 IMRT 和 3DCRT 的疗效。还进行了敏感性分析以评估各个亚组中的关系。
诊断后两年内死亡的风险在 IMRT 和 3DCRT 之间相似（36%比 37%，p=0.97）。在整个随访期间，与 3DCRT 相比，IMRT 的死亡概率没有统计学差异（p=0.8）。多变量分析表明，与 3DCRT 相比，IMRT 的死亡调整风险比在统计学上无显著升高（死亡风险比=1.54，95%置信区间=0.82-2.91，p=0.18）。敏感性分析的结果也相似。
我们来自 CCHIA 的基于人群的分析表明，对于接受原发性放化疗治疗的临床Ⅲ期 NSCLC 患者，接受 IMRT 治疗的患者的生存结果并不优于接受 3DCRT 治疗的患者。需要进一步进行前瞻性研究和成本效益分析。
