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Radiother Oncol. 2016 Dec;121(3):357-363. doi: 10.1016/j.radonc.2016.11.010. Epub 2016 Nov 23.

Two countries - Two treatment strategies for rectal cancer.

Author information

1
Department of Immunology, Genetics and Pathology, Uppsala University, Sweden. Electronic address: bengt.glimelius@igp.uu.se.
2
Department of Registration, Cancer Registry of Norway, Oslo, Norway.
3
Department of Radiation Sciences, Oncology, Umeå University, Sweden.
4
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
5
Department of Oncology and K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Norway.

Abstract

BACKGROUND AND PURPOSE:

Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are uncertain. Swedish and Norwegian oncologists have had different treatment recommendations. The aim was to evaluate local recurrence rates and survival in the two countries.

PATIENTS AND METHODS:

Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based "real world" data.

RESULTS:

Totally 29,029 Swedish and 15,456 Norwegian patients were analyzed. Resection for cure was performed in two-thirds of the patients. RT was given to 49% of Swedish patients, mainly short-course RT and to 26% of Norwegian patients, predominantly chemoradiotherapy (CRT). In Sweden, the proportion irradiated was stable whereas in Norway, an increase from 10% to 40% was seen. Local 5-year recurrence rates were initially higher in Norway (12%) than in Sweden (8%), whereas they were equally low (4%) during the latter time. No survival differences were seen, however, survival improved with time in both countries.

CONCLUSIONS:

Two entirely different approaches to preoperative therapy resulted in similar survival with initially higher local recurrence rates in Norway, but similarly low rates in later years. This raises questions about optimal RT rates and regimens.

KEYWORDS:

Local recurrence; Population data; Radiotherapy; Rectal cancer; Survival

PMID:
27887734
DOI:
10.1016/j.radonc.2016.11.010
[Indexed for MEDLINE]

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