J Korean Soc Ther Radiol Oncol.  2003 Mar;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

• Kim JH
• Kim DY
• Kim YH
• Kim WC
• Kim CY
• Seong J
• Sohn SC
• Shin HS
• Ahn YC
• Oh DH
• Oh WY
• Ryu MR
• Yoo HJ
• Lee KJ
• Lee KC
• Chun M
• Chun HJ
• Hong SE
• Kim IH

Abstract

PURPOSE: 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.
MATERIALS AND METHODS
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%).
RESULTS
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.
CONCLUSION
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.

Keyword

Rectal cancer; Patterns of care study; Radiotherapy

MeSH Terms

Colonoscopy
Consensus
Drug Therapy
Follow-Up Studies
Humans
Korea
Logic
Radiotherapy
Rectal Neoplasms*
Seoul
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography