@article{JGO20098,
author = {Waqar Haque and Vivek Verma and E. Brian Butler and Bin S. Teh},
title = {Utilization of intensity modulated radiation therapy for anal cancer in the United States},
journal = {Journal of Gastrointestinal Oncology},
volume = {9},
number = {3},
year = {2018},
keywords = {},
abstract = {Background: Chemoradiotherapy for anal cancer (AC) can incur substantial treatment-related toxicities. Whereas radiotherapy (RT) for AC has historically been delivered with two- or three-dimensional conformal RT (2D/3DCRT) techniques, intensity-modulated RT (IMRT) is associated with improved target conformality and lower doses to organs-at-risk (OARs). This is the first investigation to date evaluating trends of IMRT utilization in the United States.
Methods: The National Cancer Data Base (NCDB) was queried [2004–2015] for AC patients receiving definitive chemoradiotherapy with a defined RT technique (3DCRT versus IMRT). Following analysis based on temporal trends, multivariate logistic regression determined factors associated with receipt of IMRT. Secondarily, Kaplan-Meier analysis compared OS between the 3DCRT and IMRT groups, and Cox proportional hazards modeling determined variables associated with OS.
Results: Altogether, 11,396 patients met study criteria; 1,288 (11%) were treated with 3DCRT and 10,108 (89%) with IMRT. Temporally, utilization of IMRT rose significantly, from 28% in 2004 to 96% in 2015, corresponding with a progressive decrease in 3DCRT usage. IMRT was more likely delivered in node-positive disease, at academic centers, and in southern/western regions (P},
issn = {2219-679X}, url = {https://jgo.amegroups.org/article/view/20098}
}