Brachytherapy Is Associated With Improved Survival in Inoperable Stage I XXXX : A Population-Based Analysis.

@entity1204 @entity1 @entity5 @entity1349
PURPOSE: To assess the use of brachytherapy (BT) with or without external beam radiation (EBRT) in inoperable stage I @entity1204 in the United States and to determine the effect of BT on @entity1349 ( @entity1349 ) and cause-specific survival (CSS). METHODS AND MATERIALS: Data between 1998 and 2011 from the National @entity5 Institute's Surveillance, Epidemiology and End Results database were analyzed. Coarsened exact matching was used to adjust for differences in age and grade between @entity1 who received BT and those who did not. Prognostic factors affecting @entity1349 and CSS were evaluated using the Kaplan-Meier product-limit method and a Cox proportional hazards regression model. RESULTS: A total of 460 @entity1 with inoperable stage I @entity1204 treated with radiation therapy were identified. Radiation consisted of either EBRT (n=260) or BT with or without EBRT (n=200). The only factor associated with BT use was younger @entity1 age (median age, 72 vs 76  years, P=.001). @entity1 who received BT had a higher 3-year @entity1349 (60% vs 47%, P<.001) and CSS (82% vs 74%, P=.032) compared with those who did not. On multivariate analysis, BT use was independently associated with an improved @entity1349 (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.52-0.87) and CSS (HR 0.61, 95% CI 0.39-0.93). When @entity1 were matched on age, BT use remained significant on multivariate analysis for @entity1349 (HR 0.65, 95% CI 0.48-0.87) and CSS (HR 0.52, 95% CI 0.31-0.84). When matched on age and grade, BT remained independently associated with improved @entity1349 and CSS ( @entity1349 HR 0.62, 95% CI 0.46-0.83; CSS HR 0.57, 95% CI 0.34-0.92). CONCLUSION: Brachytherapy is independently associated with improved @entity1349 and CSS. It should be considered as part of the treatment regimen for stage I inoperable @entity1204 @entity1 undergoing radiation.
