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ORIgINAL ARTICLE Comparative Effectiveness of Intensity-Modulated Versus 3D Conformal Radiation Therapy Among Medicare Patients with Stage III Lung Cancer Aileen B. Chen, MD, MPP,* Ling Li, MSPH,† Angel Cronin, MS,† and Deborah Schrag, MD, MPH† over 5 years, some achieve long-term survival with aggressive Introduction: The clinical benefit of intensity-modulated radiation combination therapies, including radiation therapy. therapy (IMRT) compared to 3D conformal radiation (3D-RT) has The adoption of advanced radiation therapy technolo- not been well established for locally advanced non–small-cell lung gies, such as 3D conformal radiation (3D-RT) and intensity- cancer (NSCLC). modulated radiation therapy (IMRT) have allowed radiation Methods: Using SEER-Medicare, we identified Medicare benefi- oncologists to more accurately target tumor volumes while ciaries diagnosed with stage III NSCLC who received potentially reducing risk of toxicity to surrounding normal tissues. In curative (≥ 25 fractions) thoracic IMRT or 3D-RT from 2002–2009. a prior study, we found that adoption of 3D-RT, made pos- Overall survival and number of hospital days within 90 days of radia- sible by CT-based treatment planning, was associated with tion were analyzed using Cox proportional hazard and negative bino- improved outcomes among patients with stage III non–small- mial regression models, respectively. Propensity score adjustment cell lung cancer (NSCLC) receiving thoracic radiation (TRT). was used to control for clinical and
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Dec 1, 2014
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