Intensity‐modulated radiation therapy use in the U.S., 2004

Abstract

BACKGROUNDIntensity‐modulated radiation therapy (IMRT) is a novel approach to the planning and delivery of radiation therapy. The prevalence of IMRT use among radiation oncologists in the U.S. appears to be increasing, despite limited data evaluating its risks and benefits.METHODSA random sample of radiation oncologists in the U.S., including a cohort of 441 physicians who were surveyed in 2002, was surveyed regarding IMRT use. IMRT users were questioned regarding their frequency of use, clinical applications, and reasons for adopting IMRT. IMRT nonusers were asked their reasons for not using IMRT, whether they planned to use it in the future, and reasons for wanting to adopt IMRT. Differences in responses between 2002 and 2004 were compared.RESULTSThe survey was conducted between July 1, 2004 and August 31, 2004. Of 368 evaluable participants, 239 physicians (64.9%) responded. The proportion of respondents who used IMRT was 73.2% (175 physicians), compared with 32.0% in 2002. The adoption rate of IMRT among nonusers from 2002 to 2004 was 62.7% (95% confidence interval, 51.9–73.5%). Many IMRT users (81.0%) had used IMRT to deliver higher than conventional doses of radiation, predominantly in patients with genitourinary and head and neck tumors. Major reasons cited for IMRT adoption were permitting normal tissue sparing (88.0%), dose escalation (85.1%), and economic competition (62.4%). Ninety‐one percent of nonusers planned to adopt IMRT in the future.CONCLUSIONSIMRT use among radiation oncologists in the U.S. has increased significantly since 2002. Standardized guidelines and careful, prospective analyses evaluating its risks and benefits are needed. Cancer 2005. © 2005 American Cancer Society.

Survey on human papillomavirus/p16 screening use in oropharyngeal carcinoma patients in the United States

“…23 In addition, on a follow-up survey, IMRT use in 2004 was 73.2%; and, of those who were using IMRT, 80.5% used it for head and neck cancers. 24 It also was reported that the adoption rate from 2002 to 2004 was 62.7%. 24 Our study has several potential limitations.…”

“…24 It also was reported that the adoption rate from 2002 to 2004 was 62.7%. 24 Our study has several potential limitations. First, our response rate of 39.6% was quite low; however, this appears to be within the range of response rates from other published surveys among physicians.…”

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“…Much of this is made possible by intensity-modulated radiotherapy (IMRT) which has become increasingly used for postoperative cervical and endometrial cancers. 7,8 Studies have suggested significantly lower rates of acute and late toxicity using postoperative pelvic IMRT. [9][10][11][12] IMRT compared to 3D planning is currently being studied in an ongoing clinical trial (RTOG 1203).…”

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“…Of the different types of radiation therapy, one of the most commonly used in practice for treating cancer in general is intensity-modulated radiation therapy (IMRT) (Mell et al [2005]). …”