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Erschienen in:
27.01.2016 | Original Research
Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer
Erschienen in: Journal of Radiation Oncology | Ausgabe 3/2016
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Objective
The objective of this study was to investigate whether cancer-specific survival in rectal cancer patients is affected by patient-related factors, conditional on radiation treatment.
Methods
Three hundred fifty-nine invasive rectal cancer patients who consented and provided questionnaire data for a population-based case-control study of colorectal cancer in Metropolitan Detroit were included in this study. Their vital status was ascertained through to the population-based cancer registry. Hazard ratios (HR) for cancer-specific and other deaths and 95 % confidence intervals (CIs) were calculated according to selected patients’ characteristics, stratified by radiation status, using joint Cox proportional hazards models.
Results
A total of 159 patients were found to be deceased after the median follow-up of 9.2 years, and 70 % of them were considered to be cancer specific. Smoking and a history of diabetes were associated with an increased probability of deaths from other causes (HR 3.20, 95 % CI 1.72–5.97 and HR 2.02, 95 % CI 0.98–4.16, respectively), while regular use of non-steroidal anti-inflammatory drugs (NSAIDs) was inversely correlated with cancer-specific mortality (HR 0.50, 95 % CI 0.30–0.81). Furthermore, the associations of smoking and NSAIDs with the two different types of deaths (cancer vs others) significantly varied with radiation status (P values for the interactions = 0.014 for both). In addition, we observed a marginally significantly reduced risk of cancer-specific deaths in the patients who had the relative ketogenic diet (HR 0.49, 95 % 0.23–1.02).
Conclusion
Further research is warranted to confirm these results in order to develop new interventions to improve outcome from radiation treatment.