Two countries – Two treatment strategies for rectal cancer

Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are uncertain. Swedish and Norwegian oncologists have had different treatment recommendations. The aim was to evaluate local recurrence rates and survival in the two countries....

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Vydáno v:Radiotherapy and oncology Ročník 121; číslo 3; s. 357 - 363
Hlavní autoři: Glimelius, Bengt, Myklebust, Tor Åge, Lundqvist, Kristina, Wibe, Arne, Guren, Marianne G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Ireland Elsevier B.V 01.12.2016
Témata:
Aged
Chemoradiotherapy, Adjuvant - methods
Chemoradiotherapy, Adjuvant - trends
Chemoradiotherapy, Adjuvant - utilization
Female
Hematology, Oncology and Palliative Medicine
Humans
Kaplan-Meier Estimate
Local recurrence
Male
Middle Aged
Neoadjuvant Therapy - methods
Neoadjuvant Therapy - trends
Neoadjuvant Therapy - utilization
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - prevention & control
Norway - epidemiology
Population data
Preoperative Care
Professional Practice - statistics & numerical data
Professional Practice - trends
Radiotherapy
Radiotherapy, Adjuvant - methods
Radiotherapy, Adjuvant - trends
Radiotherapy, Adjuvant - utilization
Rectal cancer
Rectal Neoplasms - epidemiology
Rectal Neoplasms - radiotherapy
Rectal Neoplasms - therapy
Registries
Survival
Sweden - epidemiology
Treatment Outcome
Population data
Rectal cancer
Radiotherapy
Survival
Local recurrence
ISSN:0167-8140, 1879-0887, 1879-0887
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Shrnutí:Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are uncertain. Swedish and Norwegian oncologists have had different treatment recommendations. The aim was to evaluate local recurrence rates and survival in the two countries. Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based “real world” data. Totally 29,029 Swedish and 15,456 Norwegian patients were analyzed. Resection for cure was performed in two-thirds of the patients. RT was given to 49% of Swedish patients, mainly short-course RT and to 26% of Norwegian patients, predominantly chemoradiotherapy (CRT). In Sweden, the proportion irradiated was stable whereas in Norway, an increase from 10% to 40% was seen. Local 5-year recurrence rates were initially higher in Norway (12%) than in Sweden (8%), whereas they were equally low (4%) during the latter time. No survival differences were seen, however, survival improved with time in both countries. Two entirely different approaches to preoperative therapy resulted in similar survival with initially higher local recurrence rates in Norway, but similarly low rates in later years. This raises questions about optimal RT rates and regimens.
Bibliografie:ObjectType-Article-2
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ISSN:0167-8140
1879-0887
1879-0887
DOI:10.1016/j.radonc.2016.11.010