Prolongation of definitive head and neck cancer radiotherapy: Survival impact and predisposing factors

医学 内科学 四分位数 比例危险模型 头颈部癌 癌症 放射治疗 混淆 共病 队列 逻辑回归 延长 倾向得分匹配 危险系数 肿瘤科 外科 置信区间
作者
Michael Xiang,Michael F. Gensheimer,Erqi L. Pollom,Floyd Christopher Holsinger,A. Dimitrios Colevas,Quynh‐Thu Le,Beth M. Beadle
出处
期刊:Radiotherapy and Oncology [Elsevier BV]
卷期号:156: 201-208 被引量:16
标识
DOI:10.1016/j.radonc.2020.12.025
摘要

Abstract

Background and purpose

To quantify the survival impact of prolongation of definitive radiotherapy (RT) for head and neck cancer in a national, modern cohort, and to identify predictive factors for prolongation.

Materials and methods

The National Cancer Database was queried for adults with non-metastatic cancer of the nasopharynx, oropharynx, larynx, or hypopharynx diagnosed 2004–2015, treated with definitive RT to 66–70 Gy in 30–35 fractions at 2–2.2 Gy per fraction. Multivariable Cox regression and propensity score matching were used to model the survival impact of RT prolongation, adjusting for potential confounders such as age and comorbidity. Predictors of RT prolongation were identified using multivariable multinomial logistic regression.

Results

In total, 36,367 patients were identified. As a continuous variable, RT prolongation increased the relative hazard of death by 2% per day (P < .0001). In the matched cohorts, patients with short (4–8 days) or long prolongation (>8 days) had lower absolute 4-year overall survival by 4% and 12%, respectively (P < .0001), while prolongation of 1–3 days was not significantly adverse. Major predictors of increased risk of prolongation were administration of systemic therapy, baseline comorbidity, lack of private insurance, and tumor/nodal stage. Conversely, higher facility volume was significantly protective, with a 55% lower risk of long prolongation within the topmost quartile (>11.5 patients/year).

Conclusion

RT prolongation, especially >8 days, is significantly deleterious. Systemic therapy and facility volume were major predictors. Early identification of patients at increased risk of treatment interruptions may facilitate implementation of preventive measures.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
快递乱跑完成签到 ,获得积分10
刚刚
liu完成签到 ,获得积分10
1秒前
wyl关闭了wyl文献求助
1秒前
WYF完成签到,获得积分20
2秒前
2秒前
key发布了新的文献求助20
3秒前
叶公子完成签到,获得积分10
3秒前
醍醐不醒发布了新的文献求助20
4秒前
搜集达人应助科研眼镜蛇采纳,获得10
4秒前
Cm完成签到,获得积分10
4秒前
飞飞完成签到 ,获得积分10
4秒前
kkkk完成签到,获得积分10
5秒前
5秒前
啊懂发布了新的文献求助20
5秒前
乐乐应助芷莯采纳,获得10
6秒前
answer完成签到 ,获得积分10
6秒前
7秒前
Cm发布了新的文献求助10
7秒前
齐全完成签到 ,获得积分10
7秒前
叶公子发布了新的文献求助10
7秒前
8秒前
bot_753完成签到,获得积分10
8秒前
9秒前
9秒前
kuaikuai完成签到,获得积分10
10秒前
老朱发布了新的文献求助10
10秒前
stefan发布了新的文献求助10
10秒前
11秒前
11秒前
11秒前
上官靖完成签到,获得积分10
12秒前
zxy发布了新的文献求助10
12秒前
樱悼柳雪发布了新的文献求助10
13秒前
wyl关闭了wyl文献求助
13秒前
顾矜应助时光是个无赖采纳,获得10
13秒前
hhyma关注了科研通微信公众号
13秒前
一一一发布了新的文献求助10
13秒前
刘医生发布了新的文献求助30
14秒前
岁月星辰发布了新的文献求助10
14秒前
14秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974844
求助须知:如何正确求助?哪些是违规求助? 3519270
关于积分的说明 11197844
捐赠科研通 3255496
什么是DOI,文献DOI怎么找? 1797791
邀请新用户注册赠送积分活动 877187
科研通“疑难数据库(出版商)”最低求助积分说明 806202