Creighton University School of Medicine, Omaha, NE, USA.
Department of Medicine, CHI Health Creighton University Medical Center, Omaha, NE, USA.
Prostate Cancer Prostatic Dis. 2017 Sep;20(3):334-338. doi: 10.1038/pcan.2017.15. Epub 2017 Apr 11.
Recent studies have shown a decrease in the overall use of radiation therapy in the treatment of prostate cancer over the past several decades, as well as a more conservative overall treatment approach. We aim to determine whether this trend continued from 2004 to 2013, and to determine whether there were changes in utilization for various types of radiation.
We conducted this retrospective study using the National Cancer Database. We identified 706 877 patients with sufficient treatment information diagnosed with stage IIA prostate cancer between 2004 and 2013. Logistic regression models were used to evaluate the yearly trend in radiation therapy utilization.
There was a significant decline in the use of radiation therapy from 2004 to 2013, from 54.4% in 2004 to 34.5% in 2013 compared with all the other treatments. The use of external beam radiation therapy (EBRT) declined from 27.1% in 2004 to 25.0% in 2013, brachytherapy declined from 19.7% in 2004 to 6.1% in 2013, and combination therapy declined from 6.8% in 2004 to 2.6% in 2013. However, when considering only patients receiving radiation treatments, the use of EBRT steadily increased from 50.6% in 2004 to 74.0% in 2013, whereas the use of brachytherapy declined from 36.7% in 2004 to 18.2% in 2013. Finally, although the proportion of patients receiving combination radiation therapy initially declined from 2004 to 2009 (from 12.7 to 8.3%), there was little change in utilization from 2009 to 2013 (8.3 to 8.5%).
There has been a significant decline in the use of overall radiation therapy, as well as for each radiotherapy modality, for the treatment of prostate cancer since 2004. For patients that are receiving radiation, the use of EBRT has increased while brachytherapy use has decreased. These data serve to encourage further analysis as to the causes of these trends and how they affect patient care.
最近的研究表明，在过去几十年中，前列腺癌治疗中整体放疗的应用减少了，整体治疗方法也更为保守。我们旨在确定这一趋势是否从 2004 年持续到 2013 年，并确定各种类型放疗的应用是否发生了变化。
我们使用国家癌症数据库进行了这项回顾性研究。我们确定了 2004 年至 2013 年间 706877 例有足够治疗信息的 IIA 期前列腺癌患者。使用逻辑回归模型评估放疗利用的逐年趋势。
从 2004 年到 2013 年，放疗的应用显著下降，从 2004 年的 54.4%降至 2013 年的 34.5%，与所有其他治疗方法相比。外照射放疗（EBRT）的应用从 2004 年的 27.1%降至 2013 年的 25.0%，近距离放射治疗从 2004 年的 19.7%降至 2013 年的 6.1%，联合治疗从 2004 年的 6.8%降至 2013 年的 2.6%。然而，当仅考虑接受放疗的患者时，EBRT 的应用从 2004 年的 50.6%稳步增加到 2013 年的 74.0%，而近距离放射治疗的应用从 2004 年的 36.7%降至 2013 年的 18.2%。最后，尽管接受联合放疗的患者比例从 2004 年至 2009 年（从 12.7%降至 8.3%）有所下降，但从 2009 年至 2013 年（从 8.3%降至 8.5%）变化不大。
自 2004 年以来，前列腺癌整体放疗以及每种放疗方式的应用均显著减少。对于接受放疗的患者，EBRT 的应用增加，而近距离放射治疗的应用减少。这些数据有助于进一步分析这些趋势的原因以及它们如何影响患者护理。
