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J Korean Soc Ther Radiol Oncol > Volume 23(1); 2005 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2005;23(1): 22-31.
Postoperative Radiotherapy in the Rectal Cancers Patterns of Care Study for the Years of 1998~1999
Jong Hoon Kim, Do Hoon Oh, Ki Moon Kang, Woo Cheol Kim, Won Dong Kim, Jung Soo Kim, June Sang Kim, Jin Hee Kim, Hak Jae Kil, Chang Ok Suh, Seung Chang Sohn, Yong Chan Ahn, Dae Sik Yang, Won Yong Oh, Kyung Ja Lee, Mison Chun, Hong Rae Cho, Doo Ho Choi, Young Min Choi, Il Bong Choi, Il Han Kim
1University of Ulsan Medical College Asan Medical Center, Korea. jhkim2@amc.seoul.kr
2Hallym University Kangdong Sacred Heart Hospital, Korea.
3Gyeongsang National University Hospital, Korea.
4Inha University Hospital, Korea.
5Choongbuk National University Hospital, Korea.
6Chonbuk National University Hospital, Korea.
7Choongnam National University Hospital, Korea.
8Yeungnam University Daegu Dongsan Hospital, Korea.
9Seoul National University Hospital, Korea.
10Yonsei University Yonsei Medical Center, Korea.
11Sanggye Paik Hospital, Korea.
12Sungkyunkwan University Samsung Medical Center, Korea.
13Korea University Anam Hospital, Korea.
14National Medical Center, Korea.
15Ewha Women's University Mokdong Hospital, Korea.
16Ajou University Hospital, Korea.
17Inje University Pusan Paik Hospital, Korea.
18Soonchunhyang University Hospital, Korea.
19Dong-A University Hospital, Korea.
20Catholic University Kangnam St. Mary's Hospital, Korea.
ABSTRACT
PURPOSE:
To conduct a nationwide survey on the principles in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. MATERIASL AND
METHODS:
We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were inputted to the web based PCS system by each investigators in 19 institutions.
RESULTS:
Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum (46%). Preoperative CEA was checked in 79% of cases and its value was higher than 6 ng/ml in 32%. Pathologic stage were I in 1.6%, II in 32%, III in 63%, and IV in 1.6%. Low anterior resection was the most common type of surgery and complete resection was performed in 95% of cases. Distal resection margin was less than 2 cm in 30%, and number of lymph node dissected was less than 12 in 31%. Chemotherapy was performed in 91% and most common regimen was 5-FU and leucovorine (69%). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique (65.0%), and there was no AP-PA parallel opposing field used. Patient position was prone in 81.2%, and the boost field was used in 61.8%. To displace bowel outward, pressure modulating devices or bladder filling was used in 40.1%. Radiation dose was prescribed to isocenter in 45.3% and to isodose line in 123 cases (39.8%). Percent delivered dose over 90% was achieved in 92.9%.
CONCLUSION:
We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.
Key Words: Rectal cancer, Patterns of Care Study, Radiotherapy
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