Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar 1;120(5):702-10.
doi: 10.1002/cncr.28372. Epub 2014 Jan 13.

Improved survival using intensity-modulated radiation therapy in head and neck cancers: a SEER-Medicare analysis

Beth M Beadle  1 , Kai-Ping Liao, Linda S Elting, Thomas A Buchholz, K Kian Ang, Adam S Garden, B Ashleigh Guadagnolo
Affiliations
Free article

Improved survival using intensity-modulated radiation therapy in head and neck cancers: a SEER-Medicare analysis

Beth M Beadle et al. Cancer. .
Free article

Erratum in

  • Cancer. 2014 Jun 1;120(11):1754

Abstract

Background: Intensity-modulated radiation therapy (IMRT) is a technologically advanced, and more expensive, method of delivering radiation therapy with a goal of minimizing toxicity. It has been widely adopted for head and neck cancers; however, its comparative impact on cancer control and survival remains unknown. The goal of this analysis was to compare the cause-specific survival (CSS) for patients with head and neck cancers treated with IMRT versus non-IMRT from 1999 to 2007.

Methods: CSS was determined using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and analyzed regarding treatment details, including the use of IMRT versus non-IMRT, using claims data. Hazard ratios (HRs) were estimated by the frailty model with a propensity score matching cohort and instrumental variable analysis.

Results: A total of 3172 patients were identified. With a median follow-up of 40 months, patients treated with IMRT had a statistically significant improvement in CSS compared with those treated with non-IMRT (84.1% versus 66.0%; P < .001). When each anatomic subsite was analyzed separately, all respective subgroups of patients treated with IMRT had better CSS than those treated with non-IMRT. In multivariable survival analyses, patients treated with IMRT were associated with better CSS (HR = 0.72, 95% confidence interval = 0.59 to 0.90 for propensity score matching; HR = 0.60, 95% confidence interval = 0.41 to 0.88 for instrumental variable analysis).

Conclusions: Patients with head and neck cancers who were treated with IMRT experienced significant improvements in CSS compared with patients treated with non-IMRT techniques. This suggests there may be benefits to IMRT in cancer outcomes, in addition to toxicity reduction, for this patient population.

Keywords: SEER-Medicare; head and neck cancer; intensity-modulated radiation therapy; oropharynx cancer; radiation oncology.

PubMed Disclaimer

LinkOut - more resources