Trends and Variation in the Use of Radiotherapy in Non-metastatic Rectal Cancer: a 14-year Nationwide Overview from the Netherlands.
| Autor: | Verrijssen AE; Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands. Electronic address: an-sofie.verrijssen@catharinaziekenhuis.nl., Evers J; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, the Netherlands., van der Sangen M; Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands., Siesling S; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, the Netherlands., Aarts MJ; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Struikmans H; Department of Radiation Oncology, Leiden University Medical Centre, Leiden, the Netherlands., Bloemers MCWM; Department of Radiation Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, the Netherlands., Burger JWA; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Lemmens V; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Braam PM; Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands., Elferink MAG; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Berbee M; Department of Radiation Oncology (Maastro Clinic), School for Oncology and Reproduction (GROW), Maastricht University Medical Center, Maastricht, the Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2024 Apr; Vol. 36 (4), pp. 221-232. Date of Electronic Publication: 2024 Jan 20. |
| DOI: | 10.1016/j.clon.2024.01.013 |
| Abstrakt: | Aims: This study describes nationwide primary radiotherapy utilisation trends for non-metastasised rectal cancer in the Netherlands between 2008 and 2021. In 2014, both colorectal cancer screening and a new guideline specifying prognostic risk groups for neoadjuvant treatment were implemented. Materials and Methods: Patients with non-metastasised rectal cancer in 2008-2021 (n = 37 510) were selected from the Netherlands Cancer Registry and classified into prognostic risk groups. Treatment was studied over time and age. Multilevel logistic regression analyses were carried out to identify factors associated with (i) radiotherapy versus chemoradiotherapy use for intermediate rectal cancer and (ii) chemoradiotherapy without versus with surgery for locally advanced rectal cancer. Results: For early rectal cancer, the use of neoadjuvant radiotherapy decreased (15% to 5% between 2008 and 2021), whereas the use of endoscopic resections increased (8% in 2015, 17% in 2021). In intermediate-risk rectal cancer, neoadjuvant chemoradiotherapy (43% until 2011, 25% in 2015) shifted to radiotherapy (42% in 2008, 50% in 2015), the latter being most often applied in older patients. In locally advanced rectal cancer, the use of chemoradiotherapy without surgery increased (2-4% in 2008-2013, 17% in 2019-2021). Both neoadjuvant treatment in intermediate disease and omission of surgery following chemoradiotherapy in locally advanced disease varied with increasing age (odds ratio Conclusion: Treatment patterns in non-metastasised rectal cancer significantly changed over time. Effects of both the national screening programme and the new treatment guideline were apparent, as well as a paradigm shift towards organ preservation (watch-and-wait). Observed regional variations may indicate adoption differences regarding new treatment strategies. (Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.) |
| Databáze: | MEDLINE |
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