Int J Gynecol Cancer. 2018 Mar;28(3):563-574. doi: 10.1097/IGC.0000000000001200.
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.
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.
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).
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.
我们的目的是确定在调整已知预后因素后，立体定向体放射治疗（SBRT）、调强放射治疗（IMRT）和近距离放疗加量技术在治疗宫颈癌时的总生存率是否具有可比性。
我们使用国家癌症数据库研究了 2004 年至 2013 年间接受放疗的浸润性宫颈癌女性患者。建立逻辑回归模型以确定与 SBRT 和 IMRT 治疗相关的因素。使用 Kaplan-Meier 和倾向评分匹配比较结果。
在所有 15905 名患者中，14394 名（90.5%）接受了近距离放疗，42 名（0.8%）接受了 SBRT，1468 名（9.2%）接受了 IMRT。在进行倾向评分匹配后，接受 SBRT 加量与接受近距离放疗加量的患者的总生存率（OS）没有显著差异（危险比=1.477，95%置信区间=0.746-2.926，P=0.263），但接受 IMRT 加量与接受近距离放疗加量的患者的 OS 显著降低（危险比=1.455，95%置信区间=1.300-1.628，P<0.001）。
在倾向评分匹配分析中，接受 SBRT 加量的患者与接受近距离放疗的患者的 OS 相当，但接受 IMRT 加量的患者与接受近距离放疗的患者的 OS 较差。
