In the United States, adjuvant radiation therapy is currently recommended for most patients with rectal cancer.
Dr Baxter and colleagues from America conducted this population-based study to evaluate the rate of radiation therapy and the factors affecting its delivery.
The investigative team used the Surveillance Epidemiology and End Results database to assess treatment of patients with nonmetastatic rectal cancer diagnosed over a 25-year period from 1976 through 2000.
In this 25-year period, 45,627 patients met the selection criteria.
The team evaluated the rate of radiation therapy use and its timing preoperative versus postoperative and the influence of factors such as tumor stage and grade; patient gender and race; and geographic location.
The researchers reported that the rate of radiation therapy use increased dramatically over time: from 17% of advanced-stage patients in 1976 to 65% in 2000.
|30% of patients with advanced-stage nonmetastatic rectal cancer did not undergo radiation therapy|
|Diseases of the Colon & Rectum|
The research team observed that until 1996, the increase was due almost entirely to postoperative radiation therapy.
The team also noted that since 1996, the rate of preoperative radiation therapy use has increased and postoperative radiation therapy use has begun to decline.
The investigators found, after controlling for the year of diagnosis, that female patients, African Americans, older patients, and patients with low-grade lesions were less likely to undergo radiation therapy.
In addition, geographic location was also reported to be an important predictor of radiation therapy use.
Dr Baxter concluded, “The use of radiation therapy for patients with rectal cancer has dramatically increased over the 25-year period studied, with a recent shift to the use of preoperative radiation therapy.”
"However, in 2000, over 30% of patients with advanced-stage nonmetastatic rectal cancer did not undergo radiation therapy.”
”Given the variation in radiation therapy use that we found to be due to demographic factors, access to adjuvant radiation therapy can be improved.”