Chemotherapy Administration during Pelvic Radiation for Cervical Cancer Patients Aged ≥55 Years in the SEER-Medicare Population

Our study evaluated whether 1999 National Cancer Institute (NCI) chemoradiation guidelines for cervical cancer impacted treatment of women ≥55 years. We identified 385 women ≥55 years (median, 72 years) diagnosed with stage II-IVA cervical cancer between January, 1998 and December, 2002 in the United States Surveillance, Epidemiology, and End Results (SEER)-Medicare registries. Chemoradiation frequency tables were constructed for age, race, community setting, socioeconomic status, and comorbidity index. Of 385 women, 166 (43%) received chemoradiation as primary treatment. Prior to the 1999 NCI clinical alert, 5/43 (12%) in 1998 and 24/54 (44%) in 1999 received chemoradiation. The chemoradiation proportion was 41% (36/87) in 2000, 48% (51/107) in 2001, and 53% (50/94) in 2002 (trend, P < .01). Women ≥71 years had significantly lower odds of chemoradiation (P = .04). While SEER-Medicare data indicated an increasing trend for chemoradiation after the 1999 NCI clinical alert, chemoradiation was less frequent in elderly women with cervical cancer.