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@ARTICLE{Huang:141870,
      author       = {L. Huang$^*$ and L. Jansen$^*$ and Y. Balavarca$^*$ and L.
                      van der Geest and V. Lemmens and L. Van Eycken and H. De
                      Schutter and T. B. Johannesen and M. Primic-Žakelj and V.
                      Zadnik and M. Mägi and D. Pulte$^*$ and P. Schrotz-King$^*$
                      and H. Brenner$^*$},
      title        = {{N}onsurgical therapies for resected and unresected
                      pancreatic cancer in {E}urope and {USA} in 2003-2014: a
                      large international population-based study.},
      journal      = {International journal of cancer},
      volume       = {143},
      number       = {12},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2018-02127},
      pages        = {3227 - 3239},
      year         = {2018},
      abstract     = {The role of chemotherapy in the treatment of pancreatic
                      cancer (PaC) has been well-established, while radiation
                      plays ambiguous roles. This international large-scale
                      population-based study aimed to investigate the real-world
                      application of chemotherapy and radiotherapy for resected
                      and unresected PaC in Europe and USA. Population-based data
                      from multiple European national cancer registries and the US
                      Surveillance, Epidemiology and End Results (SEER)-18
                      database during 2003-2014 were analyzed. Temporal trends and
                      geographical variations in the application rates of
                      chemotherapy and radiotherapy were quantified using age
                      standardization. Associations of treatment with demographic
                      and clinical characteristics were assessed using
                      multivariable logistic regression. A total of 141,533 PaC
                      patients were analyzed. From 2003-2005 to 2012-2014,
                      chemotherapy administration rates increased in most
                      countries and more strongly among resected patients, while
                      radiation rates were generally low with a slight decline or
                      no obvious trend. In 2012-2014, $12.5\%$ (Estonia) to
                      $61.7\%$ (Belgium) of resected and $17.1\%$ (Slovenia) to
                      $56.9\%$ (Belgium) of unresected patients received
                      chemotherapy. Radiation was administered in $2.6\%$
                      (Netherlands) to $32.6\%$ (USA) of resected and $1.0\%$
                      (USA) to $6.0\%$ (Belgium) of unresected patients. Strong
                      temporal and geographical variations were observed. Patterns
                      and strengths of associations of treatment administration
                      with various demographic and clinical factors differed
                      substantially between resected and unresected cancers and
                      varied greatly across countries. Conclusively,
                      administration of chemotherapy but not radiotherapy for PaC
                      increased during the last decade in Europe and USA.
                      Treatment rates were low and the uptake strongly varied
                      across countries, highlighting the need for standardization
                      in PaC treatment to improve patient care.},
      cin          = {C070 / G110},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29923613},
      doi          = {10.1002/ijc.31628},
      url          = {https://inrepo02.dkfz.de/record/141870},
}