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J Korean Soc Ther Radiol Oncol > Volume 21(4); 2003 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2003;21(4): 299-305.
Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results
Woong Ki Chung, Il Han Kim, Sung Ja Ahn, Taek Keun Nam, Yoon Kyeong Oh, Ju Young Song, Byung Sik Nah, Gyung Ai Chung, Hyoung Cheol Kwon, Jung Soo Kim, Soo Kon Kim, Jeong Ku Kang, Moon June Cho, Jun Sang Kim, Sun Rock Moon, Weon Kuu Chung, Woo Yoon Park, Won Dong Kim, Eun Seog Kim, Hyong Geun Yun, Jae Sung Kim
1Chonnam National University Medical School, Korea. wkchung@chonnam.ac.kr
2Seoul National University College of Medicine, Korea.
3Chosun University Medical College, Korea.
4Chonbuk National University Medical College, Korea.
5Chonju Presbyterian Medical Center, Korea.
6Chungnam National University Medical College, Korea.
7Wonkwang University Medical College, Korea.
8Konyang University Medical College, Korea.
9Chungbuk National University College of Medicine, Korea.
10Soonchunhyang University Medical College, Korea.
11Dankook University Medical College, Korea.
12Seoul National University Bundang Hospital, Korea, Korea.
In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system.
We analyzed the clinical data of patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 in the South-west area of Korea. Eligibility criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologist who are members of Korean Southwest Radiation Oncology Group. SPSS v10.0 software was used for statistical analysis.
Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years (median, 61). Laryngeal cancer occurred predominantly in males (10:1 sex ratio). Twenty-eight patients (62%) had primary cancers in the glottis and 17 (38%) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98%). Twenty-four of 28 glottic cancer patients (86%) had AJCC (American Joint Committee on Cancer) stage I/II, but 50% (8/16) had in supraglottic cancer patients (p=0.02). Most patients (89%) had the symptom of hoarseness. Indirect laryngoscopy was done in all patients and direct laryngoscopy was performed in 43 (98%) patients. Twenty-one of 28 (75%) glottic cancer cases and 6 of 17 (35%) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18%) glottic and 8 (47%) supraglottic patients. Chemotherapy and radiation was used in 2 (7%) glottic and 3 (18%) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The fraction size was 2 Gy in 80% of glottic cancer patients compared with 1.8 Gy in 59% of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 Gy and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed for the study of the patterns of care in laryngeal cancer.
The study items for laryngeal cancer were developed. In the near future, a web system will be established based on the items investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radiotherapy.
Key Words: Larynx cancer, Radiotherapy, Patterns of care study
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