Cancer Res Treat.  2018 Jul;50(3):975-983. 10.4143/crt.2017.459.

Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016

• Park HJ
• Cho S
• Kim Y

• KMID: 2417886
• DOI: http://doi.org/10.4143/crt.2017.459

Abstract

PURPOSE
Not many studies have evaluated the adoption and dissemination of evidence-based medicine in rectal cancer radiotherapy (RT). We aimed to analyze the differences by institutional characteristics and geography in adopting evidence-based care for rectal cancer RT and factors affecting the adoption in Korea.
MATERIALS AND METHODS
Korean National Health Insurance Service claims database was used. All rectal cancer patients treated with radical surgery and adjuvant RT at the same institution in 2005-2016 were included in this study. RT within 3 months before and after surgery was regarded as preoperative and postoperative RT, respectively.
RESULTS
A total of 16,827 patients treated in 83 institutions were included in the analysis. The use of preoperative RT has substantially increased over time, from 40.6% in 2005 to 84.2% in 2016 all over the nation. The proportion of preoperative RT (54.8%) exceeded that of postoperative RT (45.2%) in 2006. However, a wide range of institutional and regional variation was observed. Compared to high-volume institutions, low-volume institutions showed late adoption and variable dissemination patterns of preoperative RT. Busan-Ulsan-Gyeongsangnam-do and Gangwon-do showed slower adoption and less use of preoperative RT than other region.
CONCLUSION
We demonstrated gradual and steady increase in adoption of preoperative RT in rectal cancer treatment nationally from 2005 to 2016. Institutional variations between high- and low-volume institutions were observed.

Keyword

Rectal neoplasms; Preoperative radiotherapy; Evidence-based medicine; Patterns of care

MeSH Terms

Evidence-Based Medicine*
Gangwon-do
Geography
Humans
Korea
National Health Programs
Radiotherapy*
Rectal Neoplasms*

Figure

• 

  Fig. 1. Proportion of rectal cancer patients who received preoperative radiotherapy (RT) by year of diagnosis. (A) National average. (B) Six institutions > 1,000 cases/12 years. (C) Seven institutions with 300-499 cases/12 years. (D) Ten institutions with 200-300 cases/12 years. Vertical axis indicates the number of preoperative RT divided by the number of preoperative and postoperative RT and horizontal axis indicates year of diagnosis.

• 

  Fig. 2. Dissemination of the use of preoperative radiotherapy by year of diagnosis and location of institutions.

Reference

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