在患前列腺癌死亡风险较低的男性中使用先进的治疗技术
Bruce L Jacobs1, Yun Zhang, Florian R Schroeck
1Department of Urology, University of Michigan, Ann Arbor, MI 48109-2800, USA.
JAMA
|June 27, 2013
概括
先进的癌症治疗方法,如强度调节放射治疗 (IMRT) 和机器人前列腺切除术,越来越多地用于患有低风险前列腺癌的男性. 这一趋势甚至在非癌症死亡风险高的患者中也可见.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 医疗技术评估 医疗技术评估
背景情况:
- 采用先进的癌症治疗方法,包括强度调节放射治疗 (IMRT) 和机器人前列腺切除术,正在增加.
- 关于这些技术在低死亡风险的前列腺癌患者中传播的程度存在不确定性.
研究的目的:
- 与传统方法 (EBRT,开放性前列腺切除术) 相比,评估晚期前列腺癌治疗方法的利用率和观察.
- 专注于患有前列腺癌死亡风险较低的患者.
主要方法:
- 使用SEER-Medicare数据 (2004-2009年诊断) 的回顾性队列研究.
- 包括接受IMRT,EBRT,机器人前列腺切除术,开放前列腺切除术或观察的患者.
- 定义了低风险疾病和高风险的非癌症死亡率.
主要成果:
- 在患有低风险疾病 (32%至44%) 和高风险非癌症死亡率 (36%至57%) 的男性中,高级治疗的使用显著增加.
- 对于患有低风险疾病和高非癌症死亡风险的男性,先进治疗使用率从25%上升到34%.
- 总体而言,对于不太可能死于前列腺癌的男性,先进治疗的使用率翻了一番,从13%增加到24%.
结论:
- 在2004年至2009年期间,在被诊断患有前列腺癌的男性中,先进的治疗技术的使用明显增加.
- 这种增加明显出现在患有低风险疾病,高风险非癌症死亡率或两者的患者中.
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