Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis
Purpose To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I endometrial adenocarcinoma in the United States and to determine the effect of BT on overall survival (OS) and cause-specific survival (CSS). Methods and Materials Data between 1998 a...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2015-11, Vol.93 (3), p.649-657 |
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| creator | Acharya, Sahaja, MD Perkins, Stephanie M., MD DeWees, Todd, PhD Fischer-Valuck, Benjamin W., MD Mutch, David G., MD Powell, Matthew A., MD Schwarz, Julie K., MD, PhD Grigsby, Perry W., MS, MD |
| description | Purpose To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I endometrial adenocarcinoma in the United States and to determine the effect of BT on overall survival (OS) and cause-specific survival (CSS). Methods and Materials Data between 1998 and 2011 from the National Cancer Institute's Surveillance, Epidemiology and End Results database were analyzed. Coarsened exact matching was used to adjust for differences in age and grade between patients who received BT and those who did not. Prognostic factors affecting OS and CSS were evaluated using the Kaplan-Meier product-limit method and a Cox proportional hazards regression model. Results A total of 460 patients with inoperable stage I endometrial adenocarcinoma treated with radiation therapy were identified. Radiation consisted of either EBRT (n=260) or BT with or without EBRT (n=200). The only factor associated with BT use was younger patient age (median age, 72 vs 76 years, P =.001). Patients who received BT had a higher 3-year OS (60% vs 47%, P |
| doi_str_mv | 10.1016/j.ijrobp.2015.06.013 |
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| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22644989</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301615006343</els_id><sourcerecordid>1722423902</sourcerecordid><originalsourceid>FETCH-LOGICAL-c445t-97bcbd9fb87e93f742e4d5a320501d2179681c943a2ca71c52bc7e0cc2faa99a3</originalsourceid><addsrcrecordid>eNqFkk-P0zAQxSMEYsvCN0DIEhcuKeM_SWoOSN3VsltpJZAKgpvlOFPqktjBdir1xkfHURcOXDhZln7zZua9KYqXFJYUaP32sLSH4NtxyYBWS6iXQPmjYkFXjSx5VX17XCyA11DyDF8Uz2I8AACljXhaXLBa1BSgWRS_roI2-1PaY9DjiWwiWcfojdUJO_LVpj3ZDGPwx_zbTuFoj7on1pGN82OuaHsk26S_I9mQG9f5AVOwmVh36LzRwVjnB_2OrMknP069Tta78krHrLZ2uj9FG58XT3a6j_ji4b0svny4-Xx9V95_vN1cr-9LI0SVStm0pu3krl01KPmuEQxFV2nOoALaMdrIekWNFFwzoxtqKtaaBsEYttNaSs0vi9dnXR-TVdHYhGZvvHNokmLZECFXMlNvzlTe-eeEManBRoN9rx36KSraMCYYl8AyKs6oCT7GgDs1BjvocFIU1JyQOqhzQmpOSEGtckK57NVDh6kdsPtb9CeSDLw_A5jdOFoM87DoDHY2zLN23v6vw78CprfOGt3_wBPGg59C9j7voiJToLbzlcxHQiuAmgvOfwN_MrmI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1722423902</pqid></control><display><type>article</type><title>Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Acharya, Sahaja, MD ; Perkins, Stephanie M., MD ; DeWees, Todd, PhD ; Fischer-Valuck, Benjamin W., MD ; Mutch, David G., MD ; Powell, Matthew A., MD ; Schwarz, Julie K., MD, PhD ; Grigsby, Perry W., MS, MD</creator><creatorcontrib>Acharya, Sahaja, MD ; Perkins, Stephanie M., MD ; DeWees, Todd, PhD ; Fischer-Valuck, Benjamin W., MD ; Mutch, David G., MD ; Powell, Matthew A., MD ; Schwarz, Julie K., MD, PhD ; Grigsby, Perry W., MS, MD</creatorcontrib><description>Purpose To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I endometrial adenocarcinoma in the United States and to determine the effect of BT on overall survival (OS) and cause-specific survival (CSS). Methods and Materials Data between 1998 and 2011 from the National Cancer Institute's Surveillance, Epidemiology and End Results database were analyzed. Coarsened exact matching was used to adjust for differences in age and grade between patients who received BT and those who did not. Prognostic factors affecting OS and CSS were evaluated using the Kaplan-Meier product-limit method and a Cox proportional hazards regression model. Results A total of 460 patients with inoperable stage I endometrial adenocarcinoma treated with radiation therapy were identified. Radiation consisted of either EBRT (n=260) or BT with or without EBRT (n=200). The only factor associated with BT use was younger patient age (median age, 72 vs 76 years, P =.001). Patients who received BT had a higher 3-year OS (60% vs 47%, P <.001) and CSS (82% vs 74%, P =.032) compared with those who did not. On multivariate analysis, BT use was independently associated with an improved OS (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.52-0.87) and CSS (HR 0.61, 95% CI 0.39-0.93). When patients were matched on age, BT use remained significant on multivariate analysis for OS (HR 0.65, 95% CI 0.48-0.87) and CSS (HR 0.52, 95% CI 0.31-0.84). When matched on age and grade, BT remained independently associated with improved OS and CSS (OS HR 0.62, 95% CI 0.46-0.83; CSS HR 0.57, 95% CI 0.34-0.92). Conclusion Brachytherapy is independently associated with improved OS and CSS. It should be considered as part of the treatment regimen for stage I inoperable endometrial cancer patients undergoing radiation.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2015.06.013</identifier><identifier>PMID: 26461007</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Analysis of Variance ; BRACHYTHERAPY ; Brachytherapy - methods ; Brachytherapy - mortality ; Brachytherapy - utilization ; Cause of Death ; Endometrial Neoplasms - mortality ; Endometrial Neoplasms - pathology ; Endometrial Neoplasms - radiotherapy ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Middle Aged ; MULTIVARIATE ANALYSIS ; PATIENTS ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Retrospective Studies ; SARCOMAS ; SEER Program ; Survival Analysis</subject><ispartof>International journal of radiation oncology, biology, physics, 2015-11, Vol.93 (3), p.649-657</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-97bcbd9fb87e93f742e4d5a320501d2179681c943a2ca71c52bc7e0cc2faa99a3</citedby><cites>FETCH-LOGICAL-c445t-97bcbd9fb87e93f742e4d5a320501d2179681c943a2ca71c52bc7e0cc2faa99a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2015.06.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26461007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22644989$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Acharya, Sahaja, MD</creatorcontrib><creatorcontrib>Perkins, Stephanie M., MD</creatorcontrib><creatorcontrib>DeWees, Todd, PhD</creatorcontrib><creatorcontrib>Fischer-Valuck, Benjamin W., MD</creatorcontrib><creatorcontrib>Mutch, David G., MD</creatorcontrib><creatorcontrib>Powell, Matthew A., MD</creatorcontrib><creatorcontrib>Schwarz, Julie K., MD, PhD</creatorcontrib><creatorcontrib>Grigsby, Perry W., MS, MD</creatorcontrib><title>Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I endometrial adenocarcinoma in the United States and to determine the effect of BT on overall survival (OS) and cause-specific survival (CSS). Methods and Materials Data between 1998 and 2011 from the National Cancer Institute's Surveillance, Epidemiology and End Results database were analyzed. Coarsened exact matching was used to adjust for differences in age and grade between patients who received BT and those who did not. Prognostic factors affecting OS and CSS were evaluated using the Kaplan-Meier product-limit method and a Cox proportional hazards regression model. Results A total of 460 patients with inoperable stage I endometrial adenocarcinoma treated with radiation therapy were identified. Radiation consisted of either EBRT (n=260) or BT with or without EBRT (n=200). The only factor associated with BT use was younger patient age (median age, 72 vs 76 years, P =.001). Patients who received BT had a higher 3-year OS (60% vs 47%, P <.001) and CSS (82% vs 74%, P =.032) compared with those who did not. On multivariate analysis, BT use was independently associated with an improved OS (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.52-0.87) and CSS (HR 0.61, 95% CI 0.39-0.93). When patients were matched on age, BT use remained significant on multivariate analysis for OS (HR 0.65, 95% CI 0.48-0.87) and CSS (HR 0.52, 95% CI 0.31-0.84). When matched on age and grade, BT remained independently associated with improved OS and CSS (OS HR 0.62, 95% CI 0.46-0.83; CSS HR 0.57, 95% CI 0.34-0.92). Conclusion Brachytherapy is independently associated with improved OS and CSS. It should be considered as part of the treatment regimen for stage I inoperable endometrial cancer patients undergoing radiation.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>BRACHYTHERAPY</subject><subject>Brachytherapy - methods</subject><subject>Brachytherapy - mortality</subject><subject>Brachytherapy - utilization</subject><subject>Cause of Death</subject><subject>Endometrial Neoplasms - mortality</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrial Neoplasms - radiotherapy</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>PATIENTS</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Retrospective Studies</subject><subject>SARCOMAS</subject><subject>SEER Program</subject><subject>Survival Analysis</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk-P0zAQxSMEYsvCN0DIEhcuKeM_SWoOSN3VsltpJZAKgpvlOFPqktjBdir1xkfHURcOXDhZln7zZua9KYqXFJYUaP32sLSH4NtxyYBWS6iXQPmjYkFXjSx5VX17XCyA11DyDF8Uz2I8AACljXhaXLBa1BSgWRS_roI2-1PaY9DjiWwiWcfojdUJO_LVpj3ZDGPwx_zbTuFoj7on1pGN82OuaHsk26S_I9mQG9f5AVOwmVh36LzRwVjnB_2OrMknP069Tta78krHrLZ2uj9FG58XT3a6j_ji4b0svny4-Xx9V95_vN1cr-9LI0SVStm0pu3krl01KPmuEQxFV2nOoALaMdrIekWNFFwzoxtqKtaaBsEYttNaSs0vi9dnXR-TVdHYhGZvvHNokmLZECFXMlNvzlTe-eeEManBRoN9rx36KSraMCYYl8AyKs6oCT7GgDs1BjvocFIU1JyQOqhzQmpOSEGtckK57NVDh6kdsPtb9CeSDLw_A5jdOFoM87DoDHY2zLN23v6vw78CprfOGt3_wBPGg59C9j7voiJToLbzlcxHQiuAmgvOfwN_MrmI</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Acharya, Sahaja, MD</creator><creator>Perkins, Stephanie M., MD</creator><creator>DeWees, Todd, PhD</creator><creator>Fischer-Valuck, Benjamin W., MD</creator><creator>Mutch, David G., MD</creator><creator>Powell, Matthew A., MD</creator><creator>Schwarz, Julie K., MD, PhD</creator><creator>Grigsby, Perry W., MS, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20151101</creationdate><title>Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis</title><author>Acharya, Sahaja, MD ; Perkins, Stephanie M., MD ; DeWees, Todd, PhD ; Fischer-Valuck, Benjamin W., MD ; Mutch, David G., MD ; Powell, Matthew A., MD ; Schwarz, Julie K., MD, PhD ; Grigsby, Perry W., MS, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-97bcbd9fb87e93f742e4d5a320501d2179681c943a2ca71c52bc7e0cc2faa99a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>BRACHYTHERAPY</topic><topic>Brachytherapy - methods</topic><topic>Brachytherapy - mortality</topic><topic>Brachytherapy - utilization</topic><topic>Cause of Death</topic><topic>Endometrial Neoplasms - mortality</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrial Neoplasms - radiotherapy</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>PATIENTS</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Retrospective Studies</topic><topic>SARCOMAS</topic><topic>SEER Program</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Acharya, Sahaja, MD</creatorcontrib><creatorcontrib>Perkins, Stephanie M., MD</creatorcontrib><creatorcontrib>DeWees, Todd, PhD</creatorcontrib><creatorcontrib>Fischer-Valuck, Benjamin W., MD</creatorcontrib><creatorcontrib>Mutch, David G., MD</creatorcontrib><creatorcontrib>Powell, Matthew A., MD</creatorcontrib><creatorcontrib>Schwarz, Julie K., MD, PhD</creatorcontrib><creatorcontrib>Grigsby, Perry W., MS, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Acharya, Sahaja, MD</au><au>Perkins, Stephanie M., MD</au><au>DeWees, Todd, PhD</au><au>Fischer-Valuck, Benjamin W., MD</au><au>Mutch, David G., MD</au><au>Powell, Matthew A., MD</au><au>Schwarz, Julie K., MD, PhD</au><au>Grigsby, Perry W., MS, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>93</volume><issue>3</issue><spage>649</spage><epage>657</epage><pages>649-657</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I endometrial adenocarcinoma in the United States and to determine the effect of BT on overall survival (OS) and cause-specific survival (CSS). Methods and Materials Data between 1998 and 2011 from the National Cancer Institute's Surveillance, Epidemiology and End Results database were analyzed. Coarsened exact matching was used to adjust for differences in age and grade between patients who received BT and those who did not. Prognostic factors affecting OS and CSS were evaluated using the Kaplan-Meier product-limit method and a Cox proportional hazards regression model. Results A total of 460 patients with inoperable stage I endometrial adenocarcinoma treated with radiation therapy were identified. Radiation consisted of either EBRT (n=260) or BT with or without EBRT (n=200). The only factor associated with BT use was younger patient age (median age, 72 vs 76 years, P =.001). Patients who received BT had a higher 3-year OS (60% vs 47%, P <.001) and CSS (82% vs 74%, P =.032) compared with those who did not. On multivariate analysis, BT use was independently associated with an improved OS (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.52-0.87) and CSS (HR 0.61, 95% CI 0.39-0.93). When patients were matched on age, BT use remained significant on multivariate analysis for OS (HR 0.65, 95% CI 0.48-0.87) and CSS (HR 0.52, 95% CI 0.31-0.84). When matched on age and grade, BT remained independently associated with improved OS and CSS (OS HR 0.62, 95% CI 0.46-0.83; CSS HR 0.57, 95% CI 0.34-0.92). Conclusion Brachytherapy is independently associated with improved OS and CSS. It should be considered as part of the treatment regimen for stage I inoperable endometrial cancer patients undergoing radiation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26461007</pmid><doi>10.1016/j.ijrobp.2015.06.013</doi><tpages>9</tpages></addata></record> |
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| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Adult Age Factors Aged Aged, 80 and over Analysis of Variance BRACHYTHERAPY Brachytherapy - methods Brachytherapy - mortality Brachytherapy - utilization Cause of Death Endometrial Neoplasms - mortality Endometrial Neoplasms - pathology Endometrial Neoplasms - radiotherapy Female Hematology, Oncology and Palliative Medicine Humans Middle Aged MULTIVARIATE ANALYSIS PATIENTS Radiology RADIOLOGY AND NUCLEAR MEDICINE Retrospective Studies SARCOMAS SEER Program Survival Analysis |
| title | Brachytherapy Is Associated With Improved Survival in Inoperable Stage I Endometrial Adenocarcinoma: A Population-Based Analysis |
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