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

Sharon A. Dobie, Joan L. Warren, Barbara Matthews, David Schwartz, Laura Mae Baldwin, Kevin Billingsley

    Research output: Contribution to journalArticle

    43 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)789-799
    Number of pages11
    JournalCancer
    Volume112
    Issue number4
    DOIs
    StatePublished - Feb 15 2008

    Fingerprint

    Rectal Neoplasms
    Survival
    Population
    Therapeutics
    Mortality
    Radiation
    Adjuvant Chemotherapy
    Drug Therapy
    Neoplasms
    Medicare
    Radiotherapy
    Logistic Models

    Keywords

    • Adjuvant therapy
    • Cancer mortality
    • Chemotherapy
    • Radiation therapy
    • Rectal cancer

    ASJC Scopus subject areas

    • Cancer Research
    • Oncology

    Cite this

    Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population. / Dobie, Sharon A.; Warren, Joan L.; Matthews, Barbara; Schwartz, David; Baldwin, Laura Mae; Billingsley, Kevin.

    In: Cancer, Vol. 112, No. 4, 15.02.2008, p. 789-799.

    Research output: Contribution to journalArticle

    Dobie, Sharon A. ; Warren, Joan L. ; Matthews, Barbara ; Schwartz, David ; Baldwin, Laura Mae ; Billingsley, Kevin. / Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population. In: Cancer. 2008 ; Vol. 112, No. 4. pp. 789-799.
    @article{f314a89226b2469599a1e298b4dbbeef,
    title = "Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population",
    abstract = "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.",
    keywords = "Adjuvant therapy, Cancer mortality, Chemotherapy, Radiation therapy, Rectal cancer",
    author = "Dobie, {Sharon A.} and Warren, {Joan L.} and Barbara Matthews and David Schwartz and Baldwin, {Laura Mae} and Kevin Billingsley",
    year = "2008",
    month = "2",
    day = "15",
    doi = "10.1002/cncr.23244",
    language = "English (US)",
    volume = "112",
    pages = "789--799",
    journal = "Cancer",
    issn = "0008-543X",
    publisher = "John Wiley and Sons Inc.",
    number = "4",

    }

    TY - JOUR

    T1 - Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population

    AU - Dobie, Sharon A.

    AU - Warren, Joan L.

    AU - Matthews, Barbara

    AU - Schwartz, David

    AU - Baldwin, Laura Mae

    AU - Billingsley, Kevin

    PY - 2008/2/15

    Y1 - 2008/2/15

    N2 - 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.

    AB - 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.

    KW - Adjuvant therapy

    KW - Cancer mortality

    KW - Chemotherapy

    KW - Radiation therapy

    KW - Rectal cancer

    UR - http://www.scopus.com/inward/record.url?scp=39049148628&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=39049148628&partnerID=8YFLogxK

    U2 - 10.1002/cncr.23244

    DO - 10.1002/cncr.23244

    M3 - Article

    C2 - 18189291

    AN - SCOPUS:39049148628

    VL - 112

    SP - 789

    EP - 799

    JO - Cancer

    JF - Cancer

    SN - 0008-543X

    IS - 4

    ER -