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J Korean Soc Ther Radiol Oncol > Volume 25(2); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(2): 79-92.
Preliminary Report of the 1998~1999 Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea
Won Joo Hur, Youngmin Choi, Hyung Sik Lee, Jeung Kee Kim, Il Han Kim, Ho Jun Lee, Kyu Chan Lee, Jung Soo Kim, Mi Son Chun, Jin Hee Kim, Yong Chan Ahn, Sang Gi Kim, Bo Kyung Kim, Taek Keun Nam, Doo Ho Choi, Ki Mun Kang, Byung Hyun Kwon, Dae Yong Kim, Ji Young Jang, Seung Chang Sohn, Hyun Suk Suh, Dae Sik Yang, Woo Chul Kim, Chang Ok Suh, Kijung Ahn, Tae Sik Jeung
1Dong-A University Hospital, Korea. wjhur@dau.ac.kr
2Seoul National University Hospital, Korea.
3Maryknoll Hospital, Korea.
4Gacjon Gil Hospital, Korea.
5Chonbuk National University Hospital, Korea.
6Ajou University Hospital, Korea.
7Keimyung University Hospital, Korea.
8Sungkyunkwan University Hospital, Korea.
9Kyunghee University Hospital, Korea.
10Dankook University Hospital, Korea.
11Chonnam National University Hospital, Korea.
12Soonchunhyang University Hospital, Korea.
13Gyeongsang National University Hospital, Korea.
14Busan National University Hospital, Korea.
15National Medical Center, Korea.
16Chosun University Hospital, Korea.
17Sanggye Paik Hospital, Korea.
18Ewha Woamns University Hospital, Korea.
19Korea University Hospital, Korea.
20Inha University Hospital, Korea.
21Yonsei University Hospital, Korea.
22Inje University Hospital, Korea.
23Kosin University Gospel Hospital, Korea.
For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database.
During 1998~1999, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test.
The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered 3~4 times. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%).
For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.
Key Words: Esophageal cancer, Patterns of care study, Radiotherapy
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