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Improved Survival Using Intensity-Modulated Radiation Therapy in Head and Neck Cancers
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Improved Survival Using Intensity-Modulated Radiation Therapy in Head and Neck Cancers CANCER Beadle, B. M., Liao, K., Elting, L. S., Buchholz, T. A., Ang, K. K., Garden, A. S., Guadagnolo, B. A. 2014; 120 (5): 702-710Abstract
Intensity-modulated radiation therapy (IMRT) is a technologically advanced, and more expensive, method of delivering radiation therapy with a goal of minimizing toxicity. It has been widely adopted for head and neck cancers; however, its comparative impact on cancer control and survival remains unknown. The goal of this analysis was to compare the cause-specific survival (CSS) for patients with head and neck cancers treated with IMRT versus non-IMRT from 1999 to 2007.CSS was determined using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and analyzed regarding treatment details, including the use of IMRT versus non-IMRT, using claims data. Hazard ratios (HRs) were estimated by the frailty model with a propensity score matching cohort and instrumental variable analysis.A total of 3172 patients were identified. With a median follow-up of 40 months, patients treated with IMRT had a statistically significant improvement in CSS compared with those treated with non-IMRT (84.1% versus 66.0%; P
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