Population-level utilisation of neoadjuvant radiotherapy for the treatment of rectal cancer.

Gugusheff, J; White, K; Fitzadam, S; Creighton, N; Engel, A; Lee, M; Thompson, SR; Chantrill, L; Young, J; Currow, D

Population-level utilisation of neoadjuvant radiotherapy for the treatment of rectal cancer.

Gugusheff, J White, K Fitzadam, S Creighton, N Engel, A Lee, M Thompson, SR Chantrill, L Young, J Currow, D

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Journal of Surgical Oncology, 2022, 126, (2), pp. 322-329
Issue Date:: 2022-08

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Field	Value	Language
dc.contributor.author	Gugusheff, J
dc.contributor.author	White, K
dc.contributor.author	Fitzadam, S
dc.contributor.author	Creighton, N
dc.contributor.author	Engel, A
dc.contributor.author	Lee, M
dc.contributor.author	Thompson, SR
dc.contributor.author	Chantrill, L
dc.contributor.author	Young, J
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.date.accessioned	2022-10-06T05:28:53Z
dc.date.available	2022-03-13
dc.date.available	2022-10-06T05:28:53Z
dc.date.issued	2022-08
dc.identifier.citation	Journal of Surgical Oncology, 2022, 126, (2), pp. 322-329
dc.identifier.issn	0022-4790
dc.identifier.issn	1096-9098
dc.identifier.uri	http://hdl.handle.net/10453/162365
dc.description.abstract	PURPOSE: International clinical guidelines recommend long- or short-course neoadjuvant radiotherapy for locally advanced rectal cancer. This study aims to examine variation in the use of neoadjuvant radiotherapy for rectal cancer and identify patient and hospital factors that underpin this variation. METHODS AND MATERIALS: We conducted a retrospective, consecutive cohort study using statewide hospitalisation and radiotherapy data from New South Wales, Australia, 2013-2018. Included participants had a primary rectal adenocarcinoma and underwent surgical resection. Factors associated with the use or not of any neoadjuvant radiotherapy, and short versus long-course were explored using multilevel logistic regression models. RESULTS: Of the 2912 people included in the study, 43% received neoadjuvant radiotherapy. There was significant variation in the use of neoadjuvant radiotherapy depending on geographic location. Abdominoperineal excision (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.53-2.28) and having surgery in a public hospital (OR = 2.34, 95% CI = 1.92-2.87) were both predictors of use. Among those receiving neoadjuvant radiotherapy, 17% received short-course therapy, with short-course declining over the study period. CONCLUSIONS: The use of neoadjuvant radiotherapy for rectal cancer is highly variable, with differences only partially explained by assessable patient-or hospital-level factors. Understanding neoadjuvant radiotherapy utilisation patterns may assist in identifying barriers and opportunities to improve adherence to clinical guidelines.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Journal of Surgical Oncology
dc.relation.isbasedon	10.1002/jso.26872
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1112 Oncology and Carcinogenesis
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.mesh	Chemoradiotherapy
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Humans
dc.subject.mesh	Neoadjuvant Therapy
dc.subject.mesh	Neoplasm Staging
dc.subject.mesh	Rectal Neoplasms
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Chemoradiotherapy
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Humans
dc.subject.mesh	Neoadjuvant Therapy
dc.subject.mesh	Neoplasm Staging
dc.subject.mesh	Rectal Neoplasms
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Humans
dc.subject.mesh	Rectal Neoplasms
dc.subject.mesh	Neoplasm Staging
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Neoadjuvant Therapy
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Chemoradiotherapy
dc.title	Population-level utilisation of neoadjuvant radiotherapy for the treatment of rectal cancer.
dc.type	Journal Article
utslib.citation.volume	126
utslib.location.activity	United States
utslib.for	1112 Oncology and Carcinogenesis
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-10-06T05:28:52Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	126
utslib.citation.issue	2

Abstract:

PURPOSE: International clinical guidelines recommend long- or short-course neoadjuvant radiotherapy for locally advanced rectal cancer. This study aims to examine variation in the use of neoadjuvant radiotherapy for rectal cancer and identify patient and hospital factors that underpin this variation. METHODS AND MATERIALS: We conducted a retrospective, consecutive cohort study using statewide hospitalisation and radiotherapy data from New South Wales, Australia, 2013-2018. Included participants had a primary rectal adenocarcinoma and underwent surgical resection. Factors associated with the use or not of any neoadjuvant radiotherapy, and short versus long-course were explored using multilevel logistic regression models. RESULTS: Of the 2912 people included in the study, 43% received neoadjuvant radiotherapy. There was significant variation in the use of neoadjuvant radiotherapy depending on geographic location. Abdominoperineal excision (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.53-2.28) and having surgery in a public hospital (OR = 2.34, 95% CI = 1.92-2.87) were both predictors of use. Among those receiving neoadjuvant radiotherapy, 17% received short-course therapy, with short-course declining over the study period. CONCLUSIONS: The use of neoadjuvant radiotherapy for rectal cancer is highly variable, with differences only partially explained by assessable patient-or hospital-level factors. Understanding neoadjuvant radiotherapy utilisation patterns may assist in identifying barriers and opportunities to improve adherence to clinical guidelines.

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http://hdl.handle.net/10453/162365