Despite being widely accepted as the standard of care for locally advanced rectal cancer, neoadjuvant chemoradiation (NACRT) is only used in about half of US patients with the disease, according to a recent study.
Over the past decade, NACRT has emerged as one of the most effective treatment options for improving outcomes with minimal adverse side effects for patients with rectal cancer. Members of the American Cancer Society, led by Helmneh M. Sineshaw, MD, MPH, examined records of 66,197 patients diagnosed with rectal cancer to analyze the ways in which treatment decisions and overall survival have changed for this patient population over the last decade. They published their findings in the journal Cancer.
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The researchers compared 3 time periods: 2004-2006, 2007-2009, and 2010-2012. The use of NACRT grew significantly between each of these time periods, from 42.9% in 2004-2006, to 50% in 2007-2009, and to 55% in 2010-2012. Still, a rate of only 55% for the use of standard therapy for patients with rectal cancer is too low, researchers concluded.
Major socioeconomic factors, including lack of private insurance, were associated with a decreased likelihood of receiving NACRT. Other associated factors included older age, presence of comorbidities, large primary tumor site, lymph node involvement, ethnicity, and treatment at a facility that did not have a high case volume.
Researchers confirms that 5-year overall survival for patient treated with NACRT (72.4%) was greater than those treated with adjuvant chemoradiotherapy (70.9%), surgery alone (44.9%), or definitive chemoradiotherapy (48.8%).
Thus, researchers concluded that NACRT continues to be underused for patients with rectal cancer.
