Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008: A Population-based Study

J. J. Jobsen; M. J. Aarts; S. Siesling; J. Klaase; W. J. Louwman; P. M. P. Poortmans; M. L. M. Lybeert; C. C. E. Koning; H. Struikmans; J. W. W. Coebergh

doi:10.1016/j.clon.2011.09.009

Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008: A Population-based Study

J. J. Jobsen, M. J. Aarts, S. Siesling, J. Klaase, W. J. Louwman, P. M. P. Poortmans, M. L. M. Lybeert, C. C. E. Koning, H. Struikmans, J. W. W. Coebergh^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

14 Citations (Scopus)

Abstract

Aims: To describe variation in the utilisation rates of primary radiotherapy for patients with rectal cancer in the Netherlands, focusing on time trends and age effects.

Materials and methods: Data on primary non-metastatic rectal cancer were derived from the population-based cancer registries of four comprehensive cancer centres (regions) in the Netherlands (1997-2008, n = 13,055).

Results: An increase in the utilisation rate was noted for the four regions, from 37-46% in 1997 to 66-76% in 2008, for both genders. This increase was found predominately for preoperative radiotherapy (from 13-31% to 58-67%) and (unsurprisingly) was most pronounced for stage T2-3 patients (from 9-27% to 68-80%). The probability of receiving radiotherapy decreased with age: the odds of receiving preoperative radiotherapy was reduced in patients aged 65 years and older, as well as the odds of receiving postoperative radiotherapy in those aged 75 years and older, which remained significant after adjustment for stage, gender and region. Regional differences persisted in multivariable analyses, i.e. the odds of receiving preoperative radiotherapy was reduced in two regions: odds ratio: 0.4 (95% confidence interval: 0.4-0.5) and 0.7 (0.6-0.8). The odds of receiving postoperative radiotherapy was significantly increased in these regions [odds ratio: 2.6 (2.2-3.2) and 1.6 (1.3-1.9), respectively] and reduced in another [odds ratio 0.8 (0.6-0.96)].

Conclusions: The utilisation rate of radiotherapy for rectal cancer increased significantly over time, particularly for preoperative radiotherapy and was most pronounced for T2-3 patients. Due to national multidisciplinary treatment guidelines, regional differences became limited in recent years after adjustment for age and stage of the disease. A low utilisation rate of radiotherapy was seen in women and elderly patients. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	E1-E8
Number of pages	8
Journal	Clinical Oncology
Volume	24
Issue number	1
DOIs	https://doi.org/10.1016/j.clon.2011.09.009
Publication status	Published - Feb-2012
Externally published	Yes

Keywords

Population-based study
radiotherapy
referral
rectal cancer
utilisation rate
TOTAL MESORECTAL EXCISION
PREOPERATIVE RADIOTHERAPY
ELDERLY-PATIENTS
SOUTH NETHERLANDS
COLORECTAL-CANCER
SURVIVAL
CARCINOMA
THERAPY

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Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008
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@article{c4b4eb04a94b40d3a2a351f9dde323e1,

title = "Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008: A Population-based Study",

abstract = "Aims: To describe variation in the utilisation rates of primary radiotherapy for patients with rectal cancer in the Netherlands, focusing on time trends and age effects.Materials and methods: Data on primary non-metastatic rectal cancer were derived from the population-based cancer registries of four comprehensive cancer centres (regions) in the Netherlands (1997-2008, n = 13,055).Results: An increase in the utilisation rate was noted for the four regions, from 37-46% in 1997 to 66-76% in 2008, for both genders. This increase was found predominately for preoperative radiotherapy (from 13-31% to 58-67%) and (unsurprisingly) was most pronounced for stage T2-3 patients (from 9-27% to 68-80%). The probability of receiving radiotherapy decreased with age: the odds of receiving preoperative radiotherapy was reduced in patients aged 65 years and older, as well as the odds of receiving postoperative radiotherapy in those aged 75 years and older, which remained significant after adjustment for stage, gender and region. Regional differences persisted in multivariable analyses, i.e. the odds of receiving preoperative radiotherapy was reduced in two regions: odds ratio: 0.4 (95% confidence interval: 0.4-0.5) and 0.7 (0.6-0.8). The odds of receiving postoperative radiotherapy was significantly increased in these regions [odds ratio: 2.6 (2.2-3.2) and 1.6 (1.3-1.9), respectively] and reduced in another [odds ratio 0.8 (0.6-0.96)].Conclusions: The utilisation rate of radiotherapy for rectal cancer increased significantly over time, particularly for preoperative radiotherapy and was most pronounced for T2-3 patients. Due to national multidisciplinary treatment guidelines, regional differences became limited in recent years after adjustment for age and stage of the disease. A low utilisation rate of radiotherapy was seen in women and elderly patients. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.",

keywords = "Population-based study, radiotherapy, referral, rectal cancer, utilisation rate, TOTAL MESORECTAL EXCISION, PREOPERATIVE RADIOTHERAPY, ELDERLY-PATIENTS, SOUTH NETHERLANDS, COLORECTAL-CANCER, SURVIVAL, CARCINOMA, THERAPY",

author = "Jobsen, {J. J.} and Aarts, {M. J.} and S. Siesling and J. Klaase and Louwman, {W. J.} and Poortmans, {P. M. P.} and Lybeert, {M. L. M.} and Koning, {C. C. E.} and H. Struikmans and Coebergh, {J. W. W.}",

year = "2012",

month = feb,

doi = "10.1016/j.clon.2011.09.009",

language = "English",

volume = "24",

pages = "E1--E8",

journal = "Clinical Oncology",

issn = "0936-6555",

publisher = "ELSEVIER SCIENCE LONDON",

number = "1",

}

TY - JOUR

T1 - Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008

T2 - A Population-based Study

AU - Jobsen, J. J.

AU - Aarts, M. J.

AU - Siesling, S.

AU - Klaase, J.

AU - Louwman, W. J.

AU - Poortmans, P. M. P.

AU - Lybeert, M. L. M.

AU - Koning, C. C. E.

AU - Struikmans, H.

AU - Coebergh, J. W. W.

PY - 2012/2

Y1 - 2012/2

N2 - Aims: To describe variation in the utilisation rates of primary radiotherapy for patients with rectal cancer in the Netherlands, focusing on time trends and age effects.Materials and methods: Data on primary non-metastatic rectal cancer were derived from the population-based cancer registries of four comprehensive cancer centres (regions) in the Netherlands (1997-2008, n = 13,055).Results: An increase in the utilisation rate was noted for the four regions, from 37-46% in 1997 to 66-76% in 2008, for both genders. This increase was found predominately for preoperative radiotherapy (from 13-31% to 58-67%) and (unsurprisingly) was most pronounced for stage T2-3 patients (from 9-27% to 68-80%). The probability of receiving radiotherapy decreased with age: the odds of receiving preoperative radiotherapy was reduced in patients aged 65 years and older, as well as the odds of receiving postoperative radiotherapy in those aged 75 years and older, which remained significant after adjustment for stage, gender and region. Regional differences persisted in multivariable analyses, i.e. the odds of receiving preoperative radiotherapy was reduced in two regions: odds ratio: 0.4 (95% confidence interval: 0.4-0.5) and 0.7 (0.6-0.8). The odds of receiving postoperative radiotherapy was significantly increased in these regions [odds ratio: 2.6 (2.2-3.2) and 1.6 (1.3-1.9), respectively] and reduced in another [odds ratio 0.8 (0.6-0.96)].Conclusions: The utilisation rate of radiotherapy for rectal cancer increased significantly over time, particularly for preoperative radiotherapy and was most pronounced for T2-3 patients. Due to national multidisciplinary treatment guidelines, regional differences became limited in recent years after adjustment for age and stage of the disease. A low utilisation rate of radiotherapy was seen in women and elderly patients. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

AB - Aims: To describe variation in the utilisation rates of primary radiotherapy for patients with rectal cancer in the Netherlands, focusing on time trends and age effects.Materials and methods: Data on primary non-metastatic rectal cancer were derived from the population-based cancer registries of four comprehensive cancer centres (regions) in the Netherlands (1997-2008, n = 13,055).Results: An increase in the utilisation rate was noted for the four regions, from 37-46% in 1997 to 66-76% in 2008, for both genders. This increase was found predominately for preoperative radiotherapy (from 13-31% to 58-67%) and (unsurprisingly) was most pronounced for stage T2-3 patients (from 9-27% to 68-80%). The probability of receiving radiotherapy decreased with age: the odds of receiving preoperative radiotherapy was reduced in patients aged 65 years and older, as well as the odds of receiving postoperative radiotherapy in those aged 75 years and older, which remained significant after adjustment for stage, gender and region. Regional differences persisted in multivariable analyses, i.e. the odds of receiving preoperative radiotherapy was reduced in two regions: odds ratio: 0.4 (95% confidence interval: 0.4-0.5) and 0.7 (0.6-0.8). The odds of receiving postoperative radiotherapy was significantly increased in these regions [odds ratio: 2.6 (2.2-3.2) and 1.6 (1.3-1.9), respectively] and reduced in another [odds ratio 0.8 (0.6-0.96)].Conclusions: The utilisation rate of radiotherapy for rectal cancer increased significantly over time, particularly for preoperative radiotherapy and was most pronounced for T2-3 patients. Due to national multidisciplinary treatment guidelines, regional differences became limited in recent years after adjustment for age and stage of the disease. A low utilisation rate of radiotherapy was seen in women and elderly patients. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

KW - Population-based study

KW - radiotherapy

KW - referral

KW - rectal cancer

KW - utilisation rate

KW - TOTAL MESORECTAL EXCISION

KW - PREOPERATIVE RADIOTHERAPY

KW - ELDERLY-PATIENTS

KW - SOUTH NETHERLANDS

KW - COLORECTAL-CANCER

KW - SURVIVAL

KW - CARCINOMA

KW - THERAPY

U2 - 10.1016/j.clon.2011.09.009

DO - 10.1016/j.clon.2011.09.009

M3 - Article

C2 - 21968247

SN - 0936-6555

VL - 24

SP - E1-E8

JO - Clinical Oncology

JF - Clinical Oncology

IS - 1

ER -

Use of Primary Radiotherapy for Rectal Cancer in the Netherlands between 1997 and 2008: A Population-based Study

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