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放疗、手术和化疗在癌症治愈治疗中的应用:来自 FORTY(放疗有利结果)项目的结果。

The use of radiotherapy, surgery and chemotherapy in the curative treatment of cancer: results from the FORTY (Favourable Outcomes from RadioTherapY) project.

机构信息

The University of Manchester, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.

The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.

出版信息

Br J Radiol. 2023 Dec;96(1152):20230334. doi: 10.1259/bjr.20230334. Epub 2023 Oct 24.


DOI:10.1259/bjr.20230334
PMID:37807934
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10646636/
Abstract

OBJECTIVES: Radiotherapy, surgery and chemotherapy play key roles in the curative treatment of cancer, alone and in combination. Quantifying their roles is essential for equipment provision and workforce planning. The estimate that 40% of cancer patients are cured by RT has been used extensively to inform and influence policy but is relatively old and warrants review. METHODS: Patient, tumour and treatment event data was obtained for the 5 year period from 2009 to 2013, allowing a further 5 years for survival outcomes to be known. We analysed patient-level data on utilisation of surgery, radiotherapy, and chemotherapy in cancer patients in England. Data were sourced from Public Health England, using National Cancer Registrations, the National Radiotherapy Dataset (RTDS) and the Systemic Anti-Cancer Therapy Dataset (SACT). All tumour sites (excluding C44) and ages were included. We analysed three cohorts: all patients [ = 1,029,569], patients who survived 5 years or more [ = 537,970] and patients who survived <5 years [ = 491,599]. RESULTS: Overall cancer-specific 5-year survival was 52%, and in those patients, surgery was the most common curative treatment, with 80% receiving surgery, alone or in combination; radiotherapy was delivered to 39% and chemotherapy to 29%; 45% received two and 13% all three modalities. CONCLUSIONS: The high proportion receiving multi-modality treatment emphasises the importance of integrated, resourced, multidisciplinary cancer care. Radiotherapy was delivered to almost 40% of patients who survived 5 years which underlines its importance in cancer management. ADVANCES IN KNOWLEDGE: The results are essential in planning cancer services. They also inform the public health narrative.

摘要

目的:放疗、手术和化疗在癌症的单独和联合治疗中发挥着关键作用。量化这些作用对于设备供应和劳动力规划至关重要。广泛使用的估计表明,40%的癌症患者可以通过放疗治愈,这一估计被广泛用于为政策提供信息和影响,但它相对较旧,需要进行审查。

方法:我们获取了 2009 年至 2013 年 5 年期间的患者、肿瘤和治疗事件数据,以便进一步了解 5 年的生存结果。我们分析了英格兰癌症患者手术、放疗和化疗利用情况的患者水平数据。数据来自英国公共卫生署,使用国家癌症登记处、国家放疗数据集(RTDS)和系统抗肿瘤治疗数据集(SACT)。包括所有肿瘤部位(不包括 C44)和年龄。我们分析了三个队列:所有患者[=1,029,569]、存活 5 年或以上的患者[=537,970]和存活<5 年的患者[=491,599]。

结果:总体癌症特异性 5 年生存率为 52%,在这些患者中,手术是最常见的治愈性治疗方法,单独或联合使用的患者比例为 80%;放疗比例为 39%,化疗比例为 29%;45%的患者接受了两种治疗方法,13%的患者接受了三种治疗方法。

结论:接受多模式治疗的比例较高,强调了综合、资源充足、多学科癌症护理的重要性。放疗在存活 5 年以上的患者中几乎有 40%的患者中使用,这强调了它在癌症管理中的重要性。

知识进展:研究结果对癌症服务规划至关重要。它们也为公共卫生叙事提供了信息。

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