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J Korean Soc Ther Radiol Oncol > Volume 21(1); 2003 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2003;21(1): 44-53.
Survey on Radiotherpy Protocols for the Rectal Cancers among the Korean Radiation Oncologists in 2002 for the Development of the Patterns of Care Study of Radiation Therapy
Jong Hoon Kim, Dae Yong Kim, Yong Ho Kim, Woo Cheol Kim, Chul Yong Kim, Jinsil Seong, Seung Chang Sohn, Hyun Soo Shin, Yong Chan Ahn, Do Hoon Oh, Wong Yong Oh, Mi Ryeong Ryu, Hyung Jun Yoo, Kyung Ja Lee, Kyu Chan Lee, Mison Chun, Ha Jung Chun, Seong Eon Hong, Il Han Kim
1University of Ulsan Medical College. jhkim2@amc.seoul.kr
2National Cancer Center.
3Soon Chun Hyang University Medical College.
4Inha University Medical College.
5Korea University Medical College.
6Yonsei University Medical College.
7Inje University Medical College.
8Joong Moon Medical College.
9Seong Kyun Kwan University Medical College.
10Hallym University Medical College.
11National Medical Center.
12Catholic University Medical College.
13Korea Cancer Center Hospital.
14Ewha Women's University Medical College.
15Ga Chun Medical College.
16Ajou University Medical College.
17Hanyang University Medical College.
18Kyung Hee University Medical College.
19Seoul National University Medical College, Korea.
To conduct a nationwide survery on the principles in radiotherapy for rectal cancer, and develop the framework of a database of Korean Patterns of Care Study.
A consensus committee was established to develop a tool for measuring the patterns in radiotherapy protocols for rectal cancer. The panel was composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eligibility criteria, 2) 20 items for staging work-ups and prognostic factors, 3) 7 items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) 5 radiotherapy treatment plans, 7) 4 physical/laboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncologists in charge of gastrointestinal malignancies in all hospitals (48 hospitals) in Korea to which 30 replies were received (63%).
Most of the survey items were replied to without no major differences between the repliers, but with the following items only 50% of repliers were in agreement:1) indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations.
The items where considerable disagreement was shown among the radiation oncologists seemed to make no serious difference in the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These items can be used for a basic database for the Patterns of Care Study, which will survey the practical radiotherapy patterns for rectal cancer in Korea.
Key Words: Rectal cancer, Patterns of care study, Radiotherapy
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