Factors predictive of neoadjuvant versus adjuvant chemoradiotherapy in locally advanced rectal cancer and the impact on overall survival

Autor: Courtney L. Scaife, Molly E. Gross, Thomas Bartley Pickron, Dustin Boothe, Shane Lloyd, Alex Coffman, Jonathan Frandsen
Rok vydání: 2018
Předmět:
Zdroj: Journal of Radiation Oncology. 7:213-222
ISSN: 1948-7908
1948-7894
DOI: 10.1007/s13566-018-0350-y
Popis: We investigated the effect of neoadjuvant versus adjuvant chemoradiotherapy on overall survival as well as the impact of demographic and clinical factors for the selection of each approach utilizing the National Cancer Data Base. Adult patients with stage II and stage III adenocarcinoma of the rectum diagnosed from 2004 to 2013 were included. Chi-square analysis was used to compare demographic variables and clinical stage between the patients receiving neoadjuvant and adjuvant chemoradiotherapy. Univariate and multivariate logistic regression modeling was used to identify factors predictive of each treatment strategy. Kaplan-Meier and log-rank analysis and Cox proportional hazard modeling along with propensity score matching using variables known at the time of treatment sequence decision was performed to determine the effect on survival. A separate survival analysis was conducted including margin status to illustrate its effect on survival relative to adjuvant or neoadjuvant chemoradiation therapy. A total of 20,114 patients were identified: 17,612 (87.6%) received neoadjuvant chemoradiotherapy. Factors associated with receipt of neoadjuvant chemoradiotherapy on multivariate analysis include the following: income greater than $46,000 (p
Databáze: OpenAIRE
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