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- Glimelius, Bengt, et al.
(författare)
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Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group
- 2005
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Ingår i: Acta Oncol. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 44:8, s. 904-12
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Tidskriftsartikel (refereegranskat)abstract
- Due to uncertainties regarding clinically meaningful gains from adjuvant chemotherapy after colorectal cancer surgery, several Nordic Groups in the early 1990s initiated randomised trials to prove or reject such gains. This report gives the joint analyses after a minimum 5-year follow-up. Between October 1991 and December 1997, 2 224 patients under 76 years of age with colorectal cancer stages II and III were randomised to surgery alone (n = 1 121) or adjuvant chemotherapy (n = 1 103) which varied between trials (5FU/levamisole for 12 months, n = 444; 5FU/leucovorin for 4-5 months according to either a modified Mayo Clinic schedule (n = 262) or the Nordic schedule (n = 397). Some centres also randomised patients treated with 5FU/leucovorin to+/-levamisole). A total of 812 patients had colon cancer stage II, 708 colon cancer stage III, 323 rectal cancer stage II and 368 rectal cancer stage III. All analyses were according to intention-to-treat. No statistically significant difference in overall survival, stratified for country or region, could be found in any group of patients according to stage or site. In colon cancer stage III, an absolute difference of 7% (p = 0.15), favouring chemotherapy, was seen. The present analyses corroborate a small but clinically meaningful survival gain from adjuvant chemotherapy in colon cancer stage III, but not in the other presentations.
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- Martling, A, et al.
(författare)
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Gender differences in the treatment of rectal cancer : a population based study
- 2009
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Ingår i: European Journal of Surgical Oncology. - : Saunders Elsevier. - 0748-7983 .- 1532-2157. ; 35:4, s. 427-433
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Colorectal cancer is the second most common type of cancer in both women and men in Sweden. A National Quality Register for rectal adenocarcinoma in Sweden has included 97% of all rectal cancer patients since 1995. A previous study, based on data from the treatment program register in the Stockholm-Gotland region. found that women in Stockholm received preoperative radiotherapy (RT) less often than men [Martling A. Rectal cancer: staging, radiotherapy and surgery, ISBN: 91-7349-461-5. Stockholm: Karolinska Institute: 2003].(1) The aim of this study was to assess if women and men with rectal cancer receive equal treatment oil a national level, and whether any potential dissimilarity causes measurable consequences in Outcome. regarding postoperative morbidity and mortality, turnout, recurrence and Survival.Methods: All patients with rectal cancer included in the National Quality Register between 1995 and 2002 (11 774 patients) were analysed. Gender was correlated to treatment, postoperative morbidity and mortality, local recurrence and death.Results: The proportion of women selected for preoperative RT was significantly lower than that of men (42.5% vs. 50.1%, p < 0.001). After adjustment for other prognostic factors, the significant difference in the treatment strategy among women and men persisted. Postoperative mortality was significantly higher in men than in women and the gender difference was most pronounced in irradiated patients. RT improved local control significantly in both women and men but it had no effect oil cancer specific survival.Conclusions: For unknown reasons women less often received adjuvant RT than men. The opposite appeared to be a more adequate alternative. There is a need of improved selection criteria for RT in both men and women with rectal cancer.
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