دورية أكاديمية
Stereotactic Body Radiation Therapy for the Definitive Treatment of Early Stage Kidney Cancer: A Survival Comparison With Surgery, Tumor Ablation, and Observation
| العنوان: | Stereotactic Body Radiation Therapy for the Definitive Treatment of Early Stage Kidney Cancer: A Survival Comparison With Surgery, Tumor Ablation, and Observation |
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| المؤلفون: | Stephen R. Grant, MD, Xiudong Lei, PhD, Kenneth R. Hess, PhD, Grace L. Smith, MD, MPH, Surena F. Matin, MD, Christopher G. Wood, MD, Quynh Nguyen, MD, Steven J. Frank, MD, Mitchell S. Anscher, MD, Benjamin D. Smith, MD, Jose A. Karam, MD, Chad Tang, MD |
| المصدر: | Advances in Radiation Oncology, Vol 5, Iss 3, Pp 495-502 (2020) |
| بيانات النشر: | Elsevier, 2020. |
| سنة النشر: | 2020 |
| المجموعة: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Purpose: Partial nephrectomy is the preferred definitive treatment for early stage kidney cancer, with tumor ablative techniques or active surveillance reserved for patients not undergoing surgery. Stereotactic body radiation therapy (SBRT) has emerged as a potential noninvasive alternative for patients with early stage kidney cancer not amenable to surgery, with early reports suggesting excellent rates of local control and limited toxicity. Methods and Materials: The national cancer database from 2004 to 2014 was queried for patients who received a diagnosis of T1N0M0 kidney cancer. Treatments were categorized as surgery (partial or total nephrectomy), tumor ablation (cryoablation or thermal ablation), SBRT (radiation therapy in 5 fractions or less to a total biological effective dose [BED10] of 72 or more), or observation. A propensity score was generated by multinomial logistic regression. A Cox proportional hazards model was fit to determine association between overall survival and treatment group with propensity score adjustments for patient, demographic, and treatment characteristics. Results: A total of 165,298 received surgery, 17,196 underwent tumor ablation, 104 underwent SBRT, and 18,241 were observed. Median follow-up was 51 months. On multivariable analysis, surgery, tumor ablation, and SBRT were associated with a decreased risk of death compared with observation, with hazard ratios of 0.25 (95% confidence interval, 0.24-0.26, P < .001), 0.36 (0.35-0.38, P < .001), and 0.56 (0.39-0.79, P < .001), respectively. When stratifying by BED10 and compared with observation, hazard ratio for risk of death for patients treated with SBRT to a BED10 ≥100 (n = 62) and a BED10 |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2452-1094 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S245210942030018X; https://doaj.org/toc/2452-1094 |
| DOI: | 10.1016/j.adro.2020.01.002 |
| URL الوصول: | https://doaj.org/article/0c3c91e1e35f4d9597302fdf7d79b5a3 |
| رقم الأكسشن: | edsdoj.0c3c91e1e35f4d9597302fdf7d79b5a3 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 24521094 |
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| DOI: | 10.1016/j.adro.2020.01.002 |