Better Technology But Similar Outcomes: Lessons from the University of Florida Experience with Primary Radiotherapy for Early-stage Cervix Cancer
TJ Galloway, RJ Amdur, CG Morris, AR Yeung, WM Mendenhall
Hong Kong J Radiol 2010;12:154-61
Objective: To determine if the use of more complex technology in the form of 3-dimensional treatment planning improved outcomes after primary radiotherapy for early-stage cervical cancer.
Methods: 180 Consecutive cases treated with primary radiotherapy from 1980 to 2005 for stage IB to IIB cancer of the cervix were reviewed. In 1996, we increased the cost and complexity of the planning process by changing from 2-dimensional to 3-dimensional treatment planning. The purpose of this project was to test the hypothesis that such change in treatment planning improved patient outcome.
Results: 3-Dimensional planning was not associated with better outcomes as measured by relapse-free survival or grade 3-5 toxicity.
Conclusion: At our institution, converting to 3-dimensional radiotherapy planning for cervix cancer increased the cost and complexity of treatment without improving outcomes. This observation has important implications for the implementation of new technologies beyond settings where efficacy has been clearly demonstrated.
中文摘要
技術改善但結果類似：佛羅里達大學對首次放射治療早期子宮頸癌的經驗
TJ Galloway, RJ Amdur, CG Morris, AR Yeung, WM Mendenhall
目的：探討利用較複雜的三維治療計劃技術能否改善首次放射治療早期子宮頸癌的療效。
方法：回顧1980年至2005年IB至IIB期子宮頸癌共180個連續病例。從1996年開始，由於由二維治療計 劃改為三維治療設計，因此增加了治療成本及設計的複雜性。本研究旨在測試此改變能改善治療結 果這一假設是否正確。
結果：利用無復發生存率及3至5級毒性反應作結果測量，發現三維式治療計劃並無改善病人治療結 果。
結論：根據本院經驗，把放射治療設計改為三維式會增加成本及治療的複雜性，卻未有改善病人的 治療結果。對於一些已被證實能改善治療功效的新技術而應用於其設定外時，本研究觀察結果有著 重要啟示。