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Title: Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

Abstract

Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% {+-} 7.8%; inadequate RT, 21.2% {+-} 5.6%; adequate RT, 6.8% {+-} 1.4%; p = 0.0001) and DFS (no RT, 55.1% {+-} 9.1%; inadequate RT, 57.4% {+-} 6.3%; adequate RT, 69.1% {+-} 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage andmore » age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender.« less

Authors:
 [1];  [2];  [2];  [3];  [4];  [4];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12];  [2]
  1. Department of Radiation Therapy, University of Rostock, Rostock (Germany). E-mail: rainer.fietkau@med.uni-rostock.de
  2. Departments of Radiation Therapy and Surgery, University of Erlangen, Erlangen (Germany)
  3. Department of Surgery, Klinikum Oldenburg, Oldenburg (Germany)
  4. Departments of Radiation Therapy and General Surgery, University of Goettingen, Goettingen (Germany)
  5. Institute of Pathology, University of Leipzig, Leipzig (Germany)
  6. Department of Radiation Therapy, Krankenhaus Nordwest Frankfurt, Frankfurt (Germany)
  7. Department of Radiation Therapy, Krankenhaus Klagenfurt, Klagenfurt (Austria)
  8. Department of Radiation Therapy, University of Hannover, Hannover (Germany)
  9. Department of Radiation Therapy, University of Schleswig-Holstein, Campus Kiel, Kiel (Germany)
  10. Department of Radiation Therapy, Krankenhaus Dresden-Friedrichstadt, Dresden (Germany)
  11. Department of Surgery, Klinikum St. Veit, St. Veit (Austria)
  12. Institute of Biostatistics and Clinical Epidemiology, Charite Universitary Medicine Berlin, Berlin (Germany)
Publication Date:
OSTI Identifier:
20944757
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2006.10.020; PII: S0360-3016(06)03349-9; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; MULTIVARIATE ANALYSIS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; RECTUM

Citation Formats

Fietkau, Rainer, Roedel, Claus, Hohenberger, Werner, Raab, Rudolf, Hess, Clemens, Liersch, Torsten, Becker, Heinz, Wittekind, Christian, Hutter, Matthias, Hager, Eva, Karstens, Johann, Ewald, Hermann, Christen, Norbert, Jagoditsch, Michael, Martus, Peter, and Sauer, Rolf. Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.10.020.
Fietkau, Rainer, Roedel, Claus, Hohenberger, Werner, Raab, Rudolf, Hess, Clemens, Liersch, Torsten, Becker, Heinz, Wittekind, Christian, Hutter, Matthias, Hager, Eva, Karstens, Johann, Ewald, Hermann, Christen, Norbert, Jagoditsch, Michael, Martus, Peter, & Sauer, Rolf. Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94. United States. doi:10.1016/j.ijrobp.2006.10.020.
Fietkau, Rainer, Roedel, Claus, Hohenberger, Werner, Raab, Rudolf, Hess, Clemens, Liersch, Torsten, Becker, Heinz, Wittekind, Christian, Hutter, Matthias, Hager, Eva, Karstens, Johann, Ewald, Hermann, Christen, Norbert, Jagoditsch, Michael, Martus, Peter, and Sauer, Rolf. Thu . "Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94". United States. doi:10.1016/j.ijrobp.2006.10.020.
@article{osti_20944757,
title = {Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94},
author = {Fietkau, Rainer and Roedel, Claus and Hohenberger, Werner and Raab, Rudolf and Hess, Clemens and Liersch, Torsten and Becker, Heinz and Wittekind, Christian and Hutter, Matthias and Hager, Eva and Karstens, Johann and Ewald, Hermann and Christen, Norbert and Jagoditsch, Michael and Martus, Peter and Sauer, Rolf},
abstractNote = {Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% {+-} 7.8%; inadequate RT, 21.2% {+-} 5.6%; adequate RT, 6.8% {+-} 1.4%; p = 0.0001) and DFS (no RT, 55.1% {+-} 9.1%; inadequate RT, 57.4% {+-} 6.3%; adequate RT, 69.1% {+-} 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender.},
doi = {10.1016/j.ijrobp.2006.10.020},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 67,
place = {United States},
year = {Thu Mar 15 00:00:00 EDT 2007},
month = {Thu Mar 15 00:00:00 EDT 2007}
}