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Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

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.

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Acknowledgments

We thank Ms. Barbara Rusin, Dr. Maria Samerson, and Ms. Ann Bankowski from Wayne State University for technical support and/or collection/selection of blood samples from cases and controls.

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Authors and Affiliations

  1. Department of Oncology, Wayne State University School of Medicine, Detroit, USA

    Ikuko Kato & Gregory Dyson

  2. Department of Pathology, Wayne State University School of Medicine, Detroit, USA

    Ikuko Kato & Hyeong-Reh Kim

  3. Karmanos Cancer Institute, Wayne State University, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA

    Ikuko Kato

  4. Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, USA

    Michael Snyder

  5. Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA

    Richard K. Severson

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  1. Ikuko Kato
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  2. Gregory Dyson
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  4. Hyeong-Reh Kim
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Corresponding author

Correspondence to Ikuko Kato.

Ethics declarations

The study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

Conflict of interest statement

The authors declare that they have no competing interests.

Funding sources

This work was supported by Research Grants R01-CA93817 from the National Cancer Institute and R21 DE023181 from the National Institute of Dental and Craniofacial Research and Bridge Funding from Wayne State University.

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Kato, I., Dyson, G., Snyder, M. et al. Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer. J Radiat Oncol 5, 279–286 (2016). https://doi.org/10.1007/s13566-016-0245-8

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  • DOI: https://doi.org/10.1007/s13566-016-0245-8

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