title: [Trends in the use of primary radiotherapy for cancer in the Netherlands in patients with breast, prostate, rectal and lung tumours].
abstract: OBJECTIVE
  To provide insight in the application of radiotherapy as part of primary treatment of patients with cancer in the Netherlands.
  
  
  METHODS
  Retrospective, descriptive population-based study.
  
  
  METHODS
  Data concerning patients with breast, prostate, rectal and non-small cell lung cancer were selected from the Netherlands Cancer Registry in 4 regions, covering 50% of the Dutch population. The selection concerned data from 1997-2008 and, except for prostate cancer, only patients without distant metastases were included.
  
  
  RESULTS
  Between 1997 and 2008, the use of primary external radiotherapy increased approximately 7% in breast cancer patients and approximately 30% in rectal cancer patients. In the latter group preoperative radiotherapy strongly increased, while postoperative radiotherapy decreased. For prostate cancer there was an increase in brachytherapy (9%). The use of external beam radiotherapy in patients with prostate cancer and non-small cell lung cancer remained the same. Regional differences in the extent of use of radiotherapy for breast and rectal cancer clearly decreased. These differences remained limited for external beam radiotherapy in prostate and non-small cell lung cancer. Older patients less often received radiotherapy.
  
  
  CONCLUSIONS
  The increase in use of radiotherapy for breast cancer is explained by the increase in breast conserving surgery. The trends in use in patients with rectal cancer and breast cancer are presumably related to the implementation of multidisciplinary practice guidelines. The implementation of these guidelines probably also contributed to the decrease in regional differences in the use of radiotherapy.
authors.affiliation: Leids Universitair Medisch Centrum, afd. Klinische Oncologie, Leiden, the Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Struikmans
authors.forename: Mieke J
authors.initials: MJ
authors.lastname: Aarts
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Jobsen
authors.forename: Caro C E
authors.initials: CC
authors.lastname: Koning
authors.forename: Philip M P
authors.initials: PM
authors.lastname: Poortmans
authors.forename: Marieke W J
authors.initials: MW
authors.lastname: Louwman
authors.forename: Jan Willem J
authors.initials: JW
authors.lastname: Coebergh
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D015412:Mastectomy, Segmental / Q000639:trends; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000639:trends*; D012004:Rectal Neoplasms / Q000532:radiotherapy*; D012042:Registries; D012189:Retrospective Studies