Stereotactic Body Radiation Therapy, Intensity-Modulated Radiation Therapy, and Brachytherapy Boost Modalities in Invasive Cervical Cancer: A Study of the National Cancer Data Base. Issue 3 (1st March 2018)

• Record Type: Journal Article
• Authors: O'Donnell, Barrett; Shiao, Jay C.; Pezzi, Todd A.; Waheed, Nabila; Sharma, Shelly; Bonnen, Mark D.; Ludwig, Michelle S.
• Is Part Of: International journal of gynecological cancer. Volume 28:Issue 3(2018)
• Page Start: 563
• Page End: 574
• Publication Date: 2018-03-01
• Subjects: SBRT -- Brachytherapy -- Cervical cancer -- Image-guided radiation therapy -- Boost -- IMRT -- Survival -- Biological effective dose; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000001200
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Background and Purpose: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.