Department of Surgery, University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Am J Surg. 2020 Oct;220(4):987-992. doi: 10.1016/j.amjsurg.2020.01.016. Epub 2020 Jan 13.
Certain patients are less likely to undergo appropriate cancer treatment, worsening their overall cancer survival. The purpose of this investigation was to identify factors associated with inadequate neoadjuvant radiation for rectal cancer.
The National Cancer Database was queried for patients with locally advanced rectal cancer who received neoadjuvant radiation 2006-2014. Adequate radiation was considered to be 4,500-5,040 cGy. Demographic, hospital and clinical variables were analyzed for association with inadequate radiation.
The study cohort was 34,391 patients; 1,842(5.4%) received inadequate radiation. On multivariate analysis, female gender, older age, other race, government-provided insurance, lower clinical stage and rural location correlated with inadequate radiation.
Women were 50% less likely than men to receive correct neoadjuvant radiation dosing. Other factors including age, race, insurance, clinical stage, geographic location and neoadjuvant chemotherapy were significantly associated with radiation dosing. These factors should be evaluated to determine if they can be modified to improve outcomes.
某些患者不太可能接受适当的癌症治疗，从而导致整体癌症生存率下降。本研究旨在确定与直肠癌新辅助放疗不足相关的因素。
本研究检索了 2006 年至 2014 年间接受新辅助放疗的局部晚期直肠癌患者的国家癌症数据库。将 4500-5040cGy 的放疗视为充分放疗。对人口统计学、医院和临床变量进行分析，以确定与放疗不足相关的因素。
本研究队列共 34391 例患者，其中 1842 例（5.4%）接受了不足的放疗。多因素分析显示，女性、年龄较大、其他种族、政府提供的保险、较低的临床分期和农村地区与放疗不足相关。
女性接受正确新辅助放疗剂量的可能性比男性低 50%。其他因素，包括年龄、种族、保险、临床分期、地理位置和新辅助化疗，与放疗剂量显著相关。应评估这些因素，以确定是否可以进行调整以改善结果。
