Abandonment of Routine Radiotherapy for Nonlocally Advanced Rectal Cancer and Oncological Outcomes-Reference-Cited by-同舟云学术

Abandonment of Routine Radiotherapy for Nonlocally Advanced Rectal Cancer and Oncological Outcomes

Published:2023-12-21 Issue: Volume: Page:
ISSN:2374-2437
Container-title:JAMA Oncology
language:en
Short-container-title:JAMA Oncol

Author:

Hazen Sanne-Marije J. A.¹²³,Sluckin Tania C.¹²³,Intven Martijn P. W.⁴,Beets Geerard L.⁵⁶,Beets-Tan Regina G. H.⁶⁷,Borstlap Wernard A. A.⁸,Buffart Tineke E.²⁹,Buijsen Jeroen¹⁰¹¹,Burger Jacobus W. A.¹²,van Dieren Susan²¹³,Furnée Edgar J. B.¹⁴,Geijsen E. Debby²¹⁵,Hompes Roel²⁸,Horsthuis Karin³¹⁶,Leijtens Jeroen W. A.¹⁷,Maas Monique⁷,Melenhorst Jarno⁶¹⁸,Nederend Joost¹⁹,Peeters Koen C. M. J.²⁰,Rozema Tom²¹,Tuynman Jurriaan B.¹²³,Verhoef Cornelis²²,de Vries Marianne²³,van Westreenen Henderik L.²⁴,de Wilt Johannes H.W.²⁵,Zimmerman David D. E.²⁶,Marijnen Corrie A. M.²⁷²⁸,Tanis Pieter J.²³⁸²²,Kusters Miranda¹²³,Aalbers Arend G. J.²⁹,van Aalten Susanna M.²⁹,Acherman Yair I. Z.²⁹,Algie Gijs D.²⁹,Alting von Geusau E. Boudewijn²⁹,Amelung Femke J.²⁹,Ankersmit Marjolein²⁹,Antonisse Imogeen E.²⁹,Ashruf Jesse F.²⁹,Aukema Tjeerd S.²⁹,Avenarius Henk²⁹,Bahadoer Renu R.²⁹,Bakers Frans C. H.²⁹,Bakker Ilsalien S.²⁹,Bangert Fleur²⁹,Barendse Renée M.²⁹,Bartels S. A.²⁹,Basha S.²⁹,van Bastelaar J.²⁹,Bastiaansen Antonius J. N. M.²⁹,van Beek S. C.²⁹,Beekhuis Heleen M.D.²⁹,Belgers Eric H. J.²⁹,Bemelman Willem A.²⁹,Berbée Maaike²⁹,van den Berg C.²⁹,ten Berge H. A.²⁹,de Bie Shira H.²⁹,van der Bilt Jarmila D. W.²⁹,Bisschops Robert H. C.²⁹,Bleeker W.²⁹,Blok J.²⁹,Blok Robin D.²⁹,van Bockel Liselotte W.²⁹,Boer Anniek H.²⁹,den Boer Frank C.²⁹,Boerma Evert-Jan G.²⁹,Bonjer H. Jaap²⁹,Boogerd Leonora S. F.²⁹,Borstlap Jaap²⁹,van den Bosch I.²⁹,Bosker Robbert J. I²⁹,Bosmans J. W.²⁹,Boute M. C.²⁹,Bouvy Nicole D.²⁹,Bouwman Johanna E.²⁹,Braak Sicco J.²⁹,Braat Manon N. G. J. A.²⁹,Bradshaw Jennifer²⁹,Brandsma Amarins T. A.²⁹,Brandt-Kerkhof, A.²⁹,van Breest Smallenburg Vivian²⁹,Brinkman D. J.²⁹,van den Broek Wim T.²⁹,Bruin S.²⁹,Bruns Emma R. J.²⁹,Burbach J. P. Maarten²⁹,van der Burg Sjirk W.²⁹,Burghgraef Thijs A.²⁹,Buskens Christianne J.²⁹,ten Cate David W. G.²⁹,Ceha Heleen M.²⁹,Clermonts Stefan²⁹,Cnossen Jeltsje S.²⁹,Coebergh van den Braak Robert R. J.²⁹,Coene Peter Paul L. O.²⁹,Compaan C.²⁹,Consten Esther C. J.²⁹,Corver Maaike²⁹,Crolla Rogier M. P. H.²⁹,Curutchet Sam²⁹,Daniëls-Gooszen Alette W²⁹,Darbyshire T.²⁹,Davids Paul H. P.²⁹,Deijen Charlotte L.²⁹,Dekker Emmelie N.²⁹,Dekker Jan Willem T.²⁹,Demirkiran Ahmet²⁹,Derksen Tyche²⁹,Derkx-Hendriksen M.²⁹,Diederik Arjen L.²⁹,Dijkstra F. R.²⁹,Dinaux Anne M.²⁹,Dogan Kemal²⁹,van Dop Ilse M.²⁹,Droogh-de Greve Kitty E.²⁹,Duijsens Hanneke M.H.²⁹,van Duijvendijk P.²⁹,den Dulk Marcel²⁹,Dunker Michalda S.²⁹,Duyck Johan²⁹,van Duyn Eino B.²⁹,van Eekelen C.²⁹,van Egdom Laurentine S. E.²⁹,Eijlers Bram²⁹,Eijsbouts Q. E.²⁹,El-Massoudi Youssef²⁹,van Elderen Saskia²⁹,Emmen Anouk M. L. H.²⁹,Engelbrecht Marc²⁹,van Erp Anne C.²⁹,van Essen Jeroen A.²⁹,Fabry Hans F. J.²⁹,Fassaert Thomas²⁹,Feitsma Eline A.²⁹,Ferenschild F.²⁹,Feshtali Shirin S.²⁹,Foppen J.W.²⁹,Frietman Bas²⁹,van Gangelt K.²⁹,van Geel Anne²⁹,van Geloven Anne A.W.²⁹,Gerhards Michael F.²⁹,Gerven P.²⁹,Gielkens Hugo²⁹,van Gils Renza²⁹,Goense Lucas²⁹,Gooszen Jan A. H.²⁹,Govaert Johannes A.²⁹,Govaert Marc J. P. M.²⁹,de Graaf Eelco J. R.²⁹,van Grevenstein Wilhelmina M. U.²⁹,de Groof E. Joline²⁹,de Groot Irene²⁹,de Haas Robbert J.²⁹,Haen Roel²⁹,van der Hagen S. J.²⁹,Hakkenbrak Nadia A. G.²⁹,Harlaar Joris J.²⁹,Harst E.²⁹,den Hartogh Mariska D.²⁹,Havenga Klaas²⁹,Heemskerk J.²⁹,Heeren J. F.²⁹,Heesink Vera²⁹,Heijnen B.²⁹,Heikens Joost T.²⁹,Hendriksen Ellen M.²⁹,Heres P.²⁹,van den Hoek Sjoerd²⁹,ten Hoeve H. G.²⁹,van der Hoeven Erik J. R. J.²⁹,Hoff Christiaan²⁹,Hogendoorn W.²⁹,Hogewoning Anna²⁹,Hogewoning Cornelis R. C.²⁹,Hoogendoorn Stefan²⁹,Hoogland P.²⁹,van Hoorn Francois²⁹,Huijbers A.²⁹,van der Hul René L.²⁹,van Hulst Rieke²⁹,Imani Farshad²⁹,Inberg Bas²⁹,Janssen Pedro²⁹,de Jong Chris E. J.²⁹,Jonkers Jacoline²⁹,Jongen A. C.²⁹,Jonker F. H.²⁹,Jou-Valencia Daniela²⁹,Karthaus Eleonora G.²⁹,Keizers Bas²⁹,Keijzer A.²⁹,van Kessel C.²⁹,Ketel J. M. A.²⁹,Ketelaers Stijn H. J.²⁹,Klaase J.²⁹,Kloppenberg F. W. H.²⁹,Knöps Eva²⁹,van Koeverden Sebastiaan²⁹,Kok Sylvia²⁹,Kolderman Stephanie E. M.²⁹,Kool M.E.²⁹,de Korte Fleur I.²⁹,Kortekaas Robert T. J.²⁹,Korving Julie C.²⁹,Koster Ingrid M.²⁹,Krdzalic Jasenko²⁹,Krielen Pepijn²⁹,Kroese Leonard F.²⁹,Krul Eveline J. T.²⁹,Kruyt Philip M.²⁹,Kuiper J. T.²⁹,Lahuis Derk²⁹,Lamme Bas²⁹,van Landeghem An A. G.²⁹,Lange J. F.²⁹,Leseman-Hoogenboom Mathilde M.²⁹,Lettinga Tanja²⁹,de Lijster Manou S.²⁹,Lips Daan J.²⁹,Logeman Frank²⁹,van Loon Yu-Ting²⁹,Lutke Holzik Martijn F.²⁹,Madsen E.²⁹,Mamound Aziz²⁹,Marres C. C.²⁹,Marsman Martijn S.²⁹,Martens Milou. H.²⁹,Masselink Ilse²⁹,Meerdink M.²⁹,van der Meij Wout²⁹,Meijnen Philip²⁹,Menon Anand G.²⁹,de Mey Dietrich J. L.²⁹,Mieog J. Sven. D.²⁹,Mierlo D.²⁹,de Mik Sylvana M. L.²⁹,Moelker-Galuzina Julia²⁹,Morsink Linda²⁹,Mulder Erik J.²⁹,Muller Karin²⁹,Musters Gijsbert D.²⁹,Neijenhuis Peter A.²⁹,de Nes Lindsey C. F.²⁹,Nielen M.²⁹,van den Nieuwboer Jan B. J.²⁹,Nieuwenhuis Jonanne F.²⁹,Nonner Joost²⁹,Noordman Bo J.²⁹,Nordkamp Stefi²⁹,Olthof Pim B.²⁹,Oostdijk M.²⁹,Oosterling Steven J.²⁹,Ootes Daan²⁹,Oppedijk Vera²⁹,Ott Pieter²⁹,Paul P. M. P.²⁹,Paulusma Ida²⁹,Pereboom Ilona T. A.²⁹,Peringa Jan²⁹,Pironet Zoë²⁹,Plate Joost D. J.²⁹,Polat Fatih²⁹,Poortman P.²⁹,Poodt Ingrid G. M.²⁹,Posma Lisanne A. E.²⁹,Prette Jeroen F.²⁹,Pultrum Bareld B.²⁹,Qaderi Seyed M.²⁹,Raber M.²⁹,van Rees Jan M.²⁹,Reiber Beata M. M.²⁹,Renger Rutger-Jan²⁹,ter Riele W. W.²⁹,van Rijswijk A.²⁹,Rombouts Anouk J. M.²⁹,van Rooijen S. J.²⁹,Roosen Lodewijk²⁹,Roskott-ten Brinke Ellen A.²⁹,van Rossem Charles C.²⁹,Rothbarth Joost²⁹,Rouw Dennis B.²⁹,Rutten A.²⁹,Rutten Heidi²⁹,Rutten Harm J. T.²⁹,van der Sande Marit E.²⁹,Schaafsma Boudewijn E.²⁹,Schaapman R.²⁹,Schasfoort Renske A.²⁹,Scheer M.²⁹,van der Schelling G.²⁹,Scheurkogel Merel M.²⁹,Schoonderwoerd Lotte²⁹,Schouten N.²⁹,Schouten van der Velden Arjan P.²⁹,Schreuder Anne Marthe²⁹,Schreurs Wilhelmina H.²⁹,Schuivens Puck M. E.²⁹,Sietses Colin²⁹,Simkens Geert A.²⁹,Simons Petra C. G.²⁹,Slob Marjan J.²⁹,Slooter Gerrit D.²⁹,Sluijmer H. C. E.²⁹,van der Sluis Martsje²⁹,Smakman Niels²⁹,Smalbroek Bo P.²⁹,Smeenk Robert M.²⁹,Smits Anke B.²⁹,Snijders Heleen S.²⁹,Sonneveld Dirk J. A.²⁹,Spaansen B.²⁹,van der Spek A.²⁹,Spillenaar-Bilgen Ernst J.²⁹,Spruit Patty H.²⁹,van Sprundel T.²⁹,Stam Tanja C.²⁹,van Steensel L.²⁹,Steller E.²⁹,Steup W. H.²⁹,Steur C.²⁹,Stoker Jaap²⁹,Stortelder E.²⁹,Straatman J.²⁹,Swank H. A.²⁹,Talsma Aaldert K.²⁹,Temmink Sofieke²⁹,van Tets Willem F.²⁹,The G. Y. M.²⁹,Thorensen I. M.²⁹,Tielbeek Jeroen A. W.²⁹,van Tilborg Aukje A. J. M.²⁹,van Tilborg Fiek²⁹,Tip-Pluijm B.²⁹,Toorenvliet Boudewijn R.²⁹,van Trier Dorothée²⁹,Tseng L.²⁹,van der Valk Maxime J. M.²⁹,Vanhooymissen Inge J. S.²⁹,Vasbinder G. Boudewijn C.²⁹,Veeken Cornelis J.²⁹,van de Velde Cornelis J. H.²⁹,Veltkamp S.²⁹,Velema Laura A.²⁹,van de Ven Anthony W. H.²⁹,Verdaasdonk Emiel G. G.²⁹,Verduin Wouter M.²⁹,Verhaak T.²⁹,Verhagen Tim²⁹,Verheijen Paul M.²⁹,Vermaas Maarten²⁹,Verrijssen An-Sofie E.²⁹,Verschuur Anna V. D.²⁹,Versluis-Ossenwaarde L.²⁹,Verwoerd-van Schaik Harmke²⁹,Vijfhuize S.²⁹,Vles Wouter J.²⁹,Vliegen Roy F. A.²⁹,Voeten Stijn²⁹,Voets Sophie²⁹,Vogelaar F. Jeroen²⁹,Vogelij Clementine L. A.²⁹,Vos-Westerman, Hanneke A.²⁹,de Vos tot Nederveen Cappel R. J. L.²⁹,Vrijland W. W.²⁹,Vroemen Joy C.²⁹,van Vugt Bas S. T.²⁹,Wegdam Johannes A.²⁹,van de Weijer M. A. J.²⁹,van Wely Bob J.²⁹,Westerduin Emma²⁹,Westerterp Marinke²⁹,van Westerveld Paul P.²⁹,Wetzel M.²⁹,Wevers K.²⁹,van der Wielen N.²⁹,Wiering B.²⁹,Wijma Allard G.²⁹,de Wit Bart W. K.²⁹,Wit Fennie²⁹,Witjes A. C.²⁹,Woensdregt Karlijn²⁹,van Woerden Victor²⁹,van der Wolde J.²⁹,van der Wolf Floor S. W.²⁹,van der Wolk Sander²⁹,Wouters Michel W. J. M.²⁹,Wybenga Johannes M.²⁹,Yauw Simon T. K.²⁹,van der Zaag Edwin S.²⁹,Zamaray Bobby²⁹,Zandvoort Herman J. A.²⁹,van der Zee Dennis²⁹,Zeestraten E. C.²⁹,Zeilstra Annette²⁹,Zheng Kang J.²⁹,Zorgdrager Marcel²⁹,Zwieten T.²⁹,

Affiliation:

1. Amsterdam UMC location Vrije Universiteit Amsterdam, Surgery, Amsterdam, the Netherlands

2. Department of Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, the Netherlands

3. Department of Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands

4. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands

5. Department of Surgery, the Netherlands Cancer Institute, Amsterdam, the Netherlands

6. GROW School of Oncology and Developmental Biology, University of Maastricht, Maastricht, the Netherlands

7. Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands

8. Department of Surgery, Amsterdam UMC location of the University of Amsterdam, Amsterdam, the Netherlands

9. Department of Medical Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

10. Department of Radiation Oncology, Maastricht University Medical Centre, Maastricht, the Netherlands

11. Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre, Maastricht, the Netherlands

12. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands

13. Department of Surgery and Clinical Epidemiology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands

14. Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands

15. Department of Radiation Oncology, Amsterdam UMC location of the University of Amsterdam, Amsterdam, the Netherlands

16. Department of Radiology, Amsterdam UMC location of Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

17. Department of Surgery, Laurentius Hospital, Roermond, the Netherlands

18. Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands

19. Department of Radiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands

20. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

21. Department of Radiation Oncology, Verbeeten Institute, Tilburg, the Netherlands

22. Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus Medical Center, Rotterdam, the Netherlands

23. Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands

24. Department of Surgery, Isala Hospital, Zwolle, the Netherlands

25. Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands

26. Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands

27. Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands

28. Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands

29. for the Dutch Snapshot Research Group

Abstract

ImportanceNeoadjuvant short-course radiotherapy was routinely applied for nonlocally advanced rectal cancer (cT1-3N0-1M0 with &gt;1 mm distance to the mesorectal fascia) in the Netherlands following the Dutch total mesorectal excision trial. This policy has shifted toward selective application after guideline revision in 2014.ObjectiveTo determine the association of decreased use of neoadjuvant radiotherapy with cancer-related outcomes and overall survival at a national level.Design, Setting, and ParticipantsThis multicenter, population-based, nationwide cross-sectional cohort study analyzed Dutch patients with rectal cancer who were treated in 2011 with a 4-year follow-up. A similar study was performed in 2021, analyzing all patients that were surgically treated in 2016. From these cohorts, all patients with cT1-3N0-1M0 rectal cancer and radiologically unthreatened mesorectal fascia were included in the current study. The data of the 2011 cohort were collected between May and October 2015, and the data of the 2016 cohort were collected between October 2020 and November 2021. The data were analyzed between May and October 2022.Main Outcomes and MeasuresThe main outcomes were 4-year local recurrence and overall survival rates.ResultsAmong the 2011 and 2016 cohorts, 1199 (mean [SD] age, 68 [11] years; 430 women [36%]) of 2095 patients (57.2%) and 1576 (mean [SD] age, 68 [10] years; 547 women [35%]) of 3057 patients (51.6%) had cT1-3N0-1M0 rectal cancer and were included, with proportions of neoadjuvant radiotherapy of 87% (2011) and 37% (2016). Four-year local recurrence rates were 5.8% and 5.5%, respectively (P = .99). Compared with the 2011 cohort, 4-year overall survival was significantly higher in the 2016 cohort (79.6% vs 86.4%; P &lt; .001), with lower non–cancer-related mortality (13.8% vs 6.3%; P &lt; .001).Conclusions and RelevanceThe results of this cross-sectional study suggest that an absolute 50% reduction in radiotherapy use for nonlocally advanced rectal cancer did not compromise cancer-related outcomes at a national level. Optimizing clinical staging and surgery following the Dutch total mesorectal excision trial has potentially enabled safe deintensification of treatment.

Publisher

American Medical Association (AMA)

Subject

Oncology,Cancer Research

Link

https://jamanetwork.com/journals/jamaoncology/articlepdf/2813226/jamaoncology_hazen_2023_oi_230074_1702491726.05605.pdf

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