Patterns of Care for Adjuvant Therapy in a Random Population-Based Sample of Patients Diagnosed with Colorectal Cancer

Cronin, Deirdre; Harlan, Linda C.; Potosky, Arnold L.; Clegg, Limin X.; Stevens, Jennifer; Mooney, Margaret

doi:10.1111/j.1572-0241.2006.00775.x

Cited by 83 publications

(68 citation statements)

References 43 publications

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“…The dramatic increase in pre-operative radiotherapy for rectal cancer from 2000 onwards is similar to recent US trends (Cronin et al, 2006). It is noteworthy, however, that post-operative radiotherapy is still commonly used in our population, in contrast to the USA and the Netherlands, where there has been a shift to pre-operative administration (Martijn et al, 2003;Cronin et al, 2006). In the Netherlands this was due to implementation of new guidelines, and illustrates the potential for these (which do not exist in Ireland) to influence patient management in routine practice.…”

Section: Treatment Rates and Trends Over Timesupporting

confidence: 54%

“…The increased use of chemotherapy and radiotherapy over time (10 and 12% per annum, respectively) suggests some dissemination of RCT-approved therapies into community practice. The dramatic increase in pre-operative radiotherapy for rectal cancer from 2000 onwards is similar to recent US trends (Cronin et al, 2006). It is noteworthy, however, that post-operative radiotherapy is still commonly used in our population, in contrast to the USA and the Netherlands, where there has been a shift to pre-operative administration (Martijn et al, 2003;Cronin et al, 2006).…”

Section: Treatment Rates and Trends Over Timementioning

confidence: 53%

“…Use of chemotherapy was slightly lower in our population than in US community practice (Jessup et al, 2005;Cronin et al, 2006). This was particularly true for older patients: 38% of stage III patients over 65 in Ireland had chemotherapy compared with 55% in the United States in 1991 -96 (Schrag et al, 2001a).…”

Section: Treatment Rates and Trends Over Timementioning

confidence: 80%

“…Somewhat more reassuringly, when compared with other European population-based series from the 1990s, utilization of chemotherapy in our population did not appear to be unusually low (Bouchardy et al, 2001;Faivre-Finn et al, 2002). For rectal cancer, however, radiotherapy use was low compared to both US and European populations (28% in Ireland vs 46 -62% elsewhere) (Ayanian et al, 2003;Cronin et al, 2006;Vulto et al, 2007). Possible reasons for this include a lack of guidelines, lack of centralisation and specialisation of cancer services during the study period, and a shortfall in radiation oncology services (Expert Working Group on Radiation Oncology Services, 2003).…”

Section: Treatment Rates and Trends Over Timementioning

confidence: 89%

“…Some studies have suggested that (neo-) adjuvant therapies may be under-utilized and that use depends on patient characteristics such as age or ethnicity (Schrag et al, 2001a, b;Potosky et al, 2002;Martijn et al, 2003;Cronin et 2006). However, most population-based studies originate from the United States, relate to patients diagnosed in the first half of the 1990s, and/or focus on patient subgroups (e.g.…”

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confidence: 99%

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Inequity in colorectal cancer treatment and outcomes: a population-based study

et al. 2008

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Several uncertainties surround optimal management of colorectal cancer. We investigated treatment patterns and factors influencing treatment receipt and mortality in routine clinical practice. We included 15 249 individuals, recorded by the National Cancer Registry (Ireland), with primary invasive colon or rectal tumours, diagnosed during 1994 -2002. Logistic regression and Cox proportional hazards were used to determine factors associated with treatment receipt within 1 year of diagnosis and with mortality, respectively. A total of 78% had colorectal resection, 31% chemotherapy, and 13% radiotherapy (4% colon; 28% rectum). Half of stage IV patients underwent resection. Chemotherapy and radiotherapy use increased by at least 10% per annum. There was a notable increase in pre-operative radiotherapy from 2000 onwards. Patient-related factors were significantly associated with treatment receipt. Patients who were male, older, not married, or smokers had significantly higher risks of death. Chemotherapy was significantly associated with lower mortality for stage III, but not stage II, colon cancer. For rectal cancer, pre-operative radiotherapy was associated with reduced mortality. Surgery and chemotherapy were associated with longer survival for stage IV patients. The observed inequities in treatment and outcomes suggest that there is potential for further dissemination of therapies in routine practice. Improving treatment availability overall, and equity, has the potential to reduce mortality.

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Section: Treatment Rates and Trends Over Timesupporting

confidence: 54%

Section: Treatment Rates and Trends Over Timementioning

confidence: 53%

Section: Treatment Rates and Trends Over Timementioning

confidence: 80%

Section: Treatment Rates and Trends Over Timementioning

confidence: 89%

mentioning

confidence: 99%

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Inequity in colorectal cancer treatment and outcomes: a population-based study

et al. 2008

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The impact of chronic illnesses on the use and effectiveness of adjuvant chemotherapy for colon cancer

Gross

McAvay

Guo

et al. 2007

Cancer

138

115

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In MRI, the suppression of fat signal is very important for many applications. Multipoint Dixon based water–fat separation methods are commonly used due to its robustness to B0 homogeneity compared with other fat suppression methods, such as spectral fat saturation. The traditional Cartesian k‐space trajectory based multipoint Dixon technique is sensitive to motion, such as pulsatile blood flow, resulting in artifacts that compromise image quality. This work presents a three‐point Dixon water–fat separation method using undersampled BLADE (aka PROPELLER) for motion robustness and speed. A regularized iterative reconstruction method is then proposed for reducing the streaking artifacts coming from undersampling. In this study, the performance of the regularized iterative reconstruction method is first tested by simulations and on MR phantoms. The performance of the proposed technique is then evaluated in vivo by comparing it with conventional fat suppression methods on the human brain and knee. Experiments show that the presented method delivers reliable water–fat separation results. The reconstruction method suppresses streaking artifacts typical for undersampled BLADE acquisition schemes without missing fine structures in the image. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.

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Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population

Dobie

Warren

Matthews

et al. 2008

Cancer

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BACKGROUND This study examined elderly stage II and III rectal cancer patients' adjuvant chemoradiation therapy adherence, trends in adherence over time, and the relation of levels of adherence to mortality. METHODS The authors studied 2886 stage II and III rectal cancer patients who had surgical resection and who appeared in 1992–1999 linked SEER‐Medicare claims data. The authors compared measures of adjuvant radiation and chemotherapy receipt and completion between stage II and III patients. Adjusted risk of cancer‐related 5‐year mortality was calculated by multivariate logistic regression for different levels of chemoradiation adherence among stage II and III patients. RESULTS Of the 2886 patients, 45.4% received both adjuvant radiation and chemotherapy. Stage III patients were more likely to receive chemoradiation than stage II patients. The receipt of chemoradiation by stage II patients increased significantly from 1992 to 1999. Stage III patients were more likely to complete radiation therapy (96.6%), chemotherapy (68.2%), and both modalities (67.5%) than stage II patients (91.5%, 49.8%, 47.6%, respectively). Only a complete course of both radiation and chemotherapy for both stage II (relative risk [RR] 0.74; 95% CI, 0.54, 0.97) and III (RR 0.80; 95% CI, 0.65, 0.96) decreased the adjusted 5‐year cancer mortality risk compared with counterparts with no adjuvant therapy. CONCLUSIONS Even though stage II rectal cancer patients were less likely than stage III patients to receive and complete adjuvant chemoradiation, both patient groups in the general population had lower cancer‐related mortality if they completed chemoradiation. These patients deserve support and encouragement to complete treatment. Cancer 2008. © 2008 American Cancer Society.

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Patterns of Care for Adjuvant Therapy in a Random Population-Based Sample of Patients Diagnosed with Colorectal Cancer

Cited by 83 publications

References 43 publications

Inequity in colorectal cancer treatment and outcomes: a population-based study

Inequity in colorectal cancer treatment and outcomes: a population-based study

The impact of chronic illnesses on the use and effectiveness of adjuvant chemotherapy for colon cancer

Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population

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