Skip to main content
Journal cover image

Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States.

Publication ,  Journal Article
Mowery, YM; Salama, JK; Zafar, SY; Moore, HG; Willett, CG; Czito, BG; Hopkins, MB; Palta, M
Published in: Cancer
April 15, 2017

BACKGROUND: Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. METHODS: The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice. RESULTS: Of 1659 contactable physicians, 182 responses (11%) were received. Approximately 83% treated at least 5 patients with rectal cancer annually. The majority of responding radiation oncologists (96%) preferred neoadjuvant LC-CRT for the treatment of patients with locally advanced rectal cancer and 44% never used SC-RT. Among radiation oncologists using SC-RT, respondents indicated they would not recommend this regimen for patients with low (74%) or bulky tumors (70%) and/or concern for a positive circumferential surgical resection margin (69%). The most frequent reasons for not offering SC-RT were insufficient downstaging for sphincter preservation (53%) and a desire for longer follow-up (45%). Many radiation oncologists indicated they would prescribe SC-RT for patients not receiving chemotherapy (62%) or patients with a geographic barrier to receiving LC-CRT (82%). Patient comorbidities appeared to influence regimen preferences for 79% of respondents. Approximately 20% of respondents indicated that altered oncology care reimbursement using capitated payment by diagnosis would impact their consideration of SC-RT. CONCLUSIONS: US radiation oncologists rarely use neoadjuvant SC-RT despite 3 randomized controlled trials demonstrating no significant differences in outcome compared with LC-CRT. Further research is necessary to determine whether longer follow-up coupled with the benefits of lower cost, increased patient convenience, and lower acute toxicity will increase the adoption of SC-RT by radiation oncologists in the United States. Cancer 2017;123:1434-1441. © 2016 American Cancer Society.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

April 15, 2017

Volume

123

Issue

8

Start / End Page

1434 / 1441

Location

United States

Related Subject Headings

  • United States
  • Rectal Neoplasms
  • Radiation Oncologists
  • Practice Patterns, Physicians'
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Male
  • Humans
  • Health Care Surveys
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mowery, Y. M., Salama, J. K., Zafar, S. Y., Moore, H. G., Willett, C. G., Czito, B. G., … Palta, M. (2017). Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States. Cancer, 123(8), 1434–1441. https://doi.org/10.1002/cncr.30461
Mowery, Yvonne M., Joseph K. Salama, S Yousuf Zafar, Harvey G. Moore, Christopher G. Willett, Brian G. Czito, M Benjamin Hopkins, and Manisha Palta. “Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States.Cancer 123, no. 8 (April 15, 2017): 1434–41. https://doi.org/10.1002/cncr.30461.
Mowery YM, Salama JK, Zafar SY, Moore HG, Willett CG, Czito BG, et al. Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States. Cancer. 2017 Apr 15;123(8):1434–41.
Mowery, Yvonne M., et al. “Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States.Cancer, vol. 123, no. 8, Apr. 2017, pp. 1434–41. Pubmed, doi:10.1002/cncr.30461.
Mowery YM, Salama JK, Zafar SY, Moore HG, Willett CG, Czito BG, Hopkins MB, Palta M. Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States. Cancer. 2017 Apr 15;123(8):1434–1441.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

April 15, 2017

Volume

123

Issue

8

Start / End Page

1434 / 1441

Location

United States

Related Subject Headings

  • United States
  • Rectal Neoplasms
  • Radiation Oncologists
  • Practice Patterns, Physicians'
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Male
  • Humans
  • Health Care Surveys