Faivre-Finn C, Benhamiche A M, Maingon P, Janoray P, Faivre J
Registre Bourguignon des Cancers Digestifs (INSERM CRI 95 05), Faculte de Medecine, 7 Boulevard Jeanne d'Arc, BP 87900, 21079 Dijon, France.
Radiother Oncol. 2000 Nov;57(2):137-42. doi: 10.1016/s0167-8140(00)00246-2.
To assess the use of adjuvant radiotherapy in treating rectal cancers at a population level.
From 1976 to 1996, the influence of the period of diagnosis, sex, age, type of surgical resection, place of surgical resection on the use of radiotherapy was studied. A non-conditional logistic regression was performed to obtain the odds radio for each studied period adjusted for the other variables.
The use of adjuvant radiotherapy increased over time from 14.3% in 1976-1978 to 61.7% in 1994-1996 (odds ratio (OR): 28.0 for the 1994-1996 period compared with 1976-1978). It was also influenced by age (OR: 0.26 for patients >74 years compared with those <65 years), type of resection (OR: 3.42 for abdominoperineal resection compared with anterior resection) and place of surgery (OR: 0.39 for non-university hospitals compared with university hospitals). The nature of adjuvant radiotherapy altered over time: most adjuvant radiotherapy being done postoperatively before 1988, then preoperatively subsequently.
Substantial changes have occurred in both the degree of use of adjuvant radiotherapy and in its timing. Some progress is still possible, in particular in older patients and in patients treated in non-university hospitals.
在人群层面评估辅助放疗在直肠癌治疗中的应用情况。
研究1976年至1996年期间，诊断时期、性别、年龄、手术切除类型、手术切除地点对放疗应用的影响。进行非条件逻辑回归分析，以获得针对每个研究时期经其他变量调整后的放疗比值比。
辅助放疗的应用随时间增加，从1976 - 1978年的14.3%增至1994 - 1996年的61.7%（1994 - 1996年相对于1976 - 1978年的比值比（OR）：28.0）。它还受年龄（＞74岁患者相对于＜65岁患者的OR：0.26）、切除类型（腹会阴联合切除术相对于前切除术的OR：3.42）和手术地点（非大学医院相对于大学医院的OR：0.39）影响。辅助放疗的性质随时间改变：1988年前大多数辅助放疗在术后进行，之后则在术前进行。
辅助放疗的应用程度及其时机均发生了显著变化。仍有进一步改进的空间，尤其是在老年患者和非大学医院接受治疗的患者中。
