Stereotactic Body Radiation Therapy, Intensity-Modulated Radiation Therapy, and Brachytherapy Boost Modalities in Invasive Cervical Cancer: A Study of the National Cancer Data Base

Barrett O'Donnell, Jay C. Shiao, Todd A. Pezzi, Nabila Waheed, Shelly Sharma, Mark D. Bonnen, Michelle S. Ludwig

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background and Purpose: Our objective was to determine whether stereotactic body radiotherapy (SBRT), intensity-modulated radiation therapy (IMRT), and brachytherapy boost techniques have comparable overall survival in treating cervical cancer when adjusted for known prognostic factors. Materials and Methods We used the National Cancer Database to study women with invasive cervical cancer who were treated with radiation between 2004 and 2013. A logistic regression model was built to identify factors associated with the receipt of SBRT and IMRT. Outcomes were compared using Kaplan-Meier and propensity score matching. Results: Of all 15,905 patients, 14,394 (90.5%) received brachytherapy, 42 (0.8%) received SBRT, and 1468 (9.2%) received IMRT. After propensity score matching, there was no significant difference in overall survival (OS) for patients who received SBRT boost versus brachytherapy boost (hazard ratio = 1.477, 95% confidence interval = 0.746-2.926, P = 0.263) but a significant OS detriment in patients who received IMRT boost versus brachytherapy boost (hazard ratio = 1.455, 95% confidence interval = 1.300-1.628, P < 0.001). Conclusions: In a propensity-matched analysis, those who received SBRT boost had equal OS when compared with brachytherapy, but those who received IMRT boost had worse OS when compared with brachytherapy.

Original languageEnglish (US)
Pages (from-to)563-574
Number of pages12
JournalInternational Journal of Gynecological Cancer
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2018
Externally publishedYes

Keywords

  • Biological effective dose
  • Boost
  • Brachytherapy
  • Cervical cancer
  • IMRT
  • Image-guided radiation therapy
  • SBRT
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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