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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Abstract	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.
AbstractList	Background and purpose: 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. Patients and methods: Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based “real world” data. Results: 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. Conclusions: 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. Background and purpose: 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. Patients and methods: Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based "real world" data. Results: 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. Conclusions: 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. 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. BACKGROUND AND PURPOSETrials 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.PATIENTS AND METHODSBetween 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based "real world" data.RESULTSTotally 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.CONCLUSIONSTwo 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. Abstract Background and purpose 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. Patients and methods Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based “real world” data. Results 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. Conclusions 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.
Author	Glimelius, Bengt Guren, Marianne G. Myklebust, Tor Åge Lundqvist, Kristina Wibe, Arne
Author_xml	– sequence: 1 givenname: Bengt surname: Glimelius fullname: Glimelius, Bengt email: bengt.glimelius@igp.uu.se organization: Department of Immunology, Genetics and Pathology, Uppsala University, Sweden – sequence: 2 givenname: Tor Åge surname: Myklebust fullname: Myklebust, Tor Åge organization: Department of Registration, Cancer Registry of Norway, Oslo, Norway – sequence: 3 givenname: Kristina surname: Lundqvist fullname: Lundqvist, Kristina organization: Department of Radiation Sciences, Oncology, Umeå University, Sweden – sequence: 4 givenname: Arne surname: Wibe fullname: Wibe, Arne organization: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway – sequence: 5 givenname: Marianne G. surname: Guren fullname: Guren, Marianne G. organization: Department of Oncology and K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Norway
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/27887734$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-132044$$DView record from Swedish Publication Index (Umeå universitet) https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-315924$$DView record from Swedish Publication Index (Uppsala universitet)
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Snippet	Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are uncertain. Swedish and... Abstract Background and purpose Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are... BACKGROUND AND PURPOSETrials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are... Background and purpose: Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are...
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SubjectTerms	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
Title	Two countries – Two treatment strategies for rectal cancer
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Volume	121
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