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Variation in the Use of Single- Versus Multifraction Palliative Radiation Therapy for Bone Metastases in Australia.

澳大利亚骨转移患者使用单次与多次分割姑息性放射治疗的差异。

  • 影响因子:3.70
  • DOI:10.1016/j.ijrobp.2019.08.061
  • 作者列表:"Ong WL","Foroudi F","Milne RL","Millar JL
  • 发表时间:2020-01-01
Abstract

PURPOSE:To evaluate the use of single-fraction palliative radiation therapy (SFRT) for the management of bone metastases (BM) in Victoria, Australia. METHODS AND MATERIALS:This is a population-based cohort of patients with cancer who received radiation therapy for BM between 2012 and 2017 as captured in the Victorian Radiotherapy Minimum Data Set. The primary outcome was proportion of SFRT use. The Cochrane-Armitage test for trend was used to evaluate changes in practice over time. Multivariable logistic regression was used to assess factors associated with SFRT use. RESULTS:Of the 18,158 courses of radiation therapy for BM delivered to a total of 10,956 patients, 17% were SFRT. There was no significant change in SFRT use over time, from 18% in 2012 to 19% in 2017 (P = .07). SFRT was less commonly given to the skull (4%) and spine (14%), compared with the shoulder (37%) and ribs (53%). Patients with lung cancer (21%) were most likely to receive SFRT, followed by those with prostate cancers (18%) and gastrointestinal cancers (16%). Patients from regional/remote areas were more likely to have SFRT compared with those in major cities (22% vs 16%, P < .001). Patients treated in public institutions were more likely to have SFRT compared with those treated in private institutions (22% vs 10%, P < .001). In multivariable analyses, increasing age, lung cancer, higher socioeconomic status, residence in regional/ remote areas, and being treated in public institutions were factors independently associated with increased likelihood of receiving SFRT. CONCLUSIONS:SFRT appears underused for BM in Australia over time, with variation in practice by patient, tumor, sociodemographic, geographical, and institutional provider factors.

摘要

目的: 评价在澳大利亚维多利亚州使用单部分姑息性放射治疗 (SFRT) 治疗骨转移 (BM)。 方法和材料: 这是一个基于人群的癌症患者队列,这些患者在 2012 年至 2017 年期间接受了BM的放射治疗,如在维多利亚放射治疗最小数据集中捕获的。主要结局是SFRT使用的比例。使用趋势的Cochrane-Armitage检验评价实践随时间的变化。使用多变量logistic回归评估与SFRT使用相关的因素。 结果: 在总共 18,158 例患者接受的 10,956 个BM疗程的放射治疗中,17% 例为SFRT。随着时间的推移,SFRT的使用没有显著变化,从 2012 年的 18% 增加到 2017 年的 19% (P = .07)。SFRT较少用于颅骨 (4%) 和脊柱 (14%),而肩部 (37%) 和肋骨 (53%)。肺癌患者 (21%) 最有可能接受SFRT,其次是前列腺癌 (18%) 和胃肠道癌 (16%)。与大城市相比,来自地区/偏远地区的患者更容易发生SFRT (22% vs 16%,P <.001)。在公共机构治疗的患者比在私人机构治疗的患者更容易发生SFRT (22% vs 10%,P <.001)。在多变量分析中,年龄增加、肺癌、社会经济地位较高、居住在地区/偏远地区、在公共机构接受治疗是与接受SFRT可能性增加独立相关的因素。 结论: 在澳大利亚,随着时间的推移,SFRT似乎未充分用于BM,实践中的变化受患者、肿瘤、社会人口、地理和机构提供者因素的影响。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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