Utilization of Neoadjuvant Intensity-modulated Radiation Therapy for Rectal Cancer in the United States.

BACKGROUND/AIM: Advances in technology have expanded the use of intensity-modulated radiotherapy (IMRT). The goal of this study was to investigate trends in the utilization of IMRT for rectal cancer (RC) in USA. MATERIALS AND METHODS: The National Cancer Database was queried for RC patients receiving neoadjuvant chemoradiotherapy with either IMRT or three-dimensional conformal radiation therapy (3DCRT). Differences in factors associated with receipt of 3DCRT versus IMRT were determined and temporal trends were analyzed. RESULTS: From 2005 to 2009, IMRT utilization increased, but remained constant and roughly equivalent to 3DCRT from 2010 to 2014. Patients who received IMRT were more likely to have T4 disease (p=0.014), while patients diagnosed in 2004-2006 (p<0.0001) and 2007-2008 (p=0.015) were less likely to receive IMRT. There were no significant differences in postoperative outcomes between patients receiving 3DCRT and IMRT. CONCLUSION: IMRT utilization initially increased, but is now used at similar frequencies to 3DCRT and offers similar short-term postoperative outcomes.