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KMID : 0939920180500030975
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대한암학회지
2018 Volume.50 No. 3 p.975 ~ p.983
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Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016
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Park Hae-Jin
Cho Sang-Hyun
Kim Yoon
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Abstract
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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.
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KEYWORD
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Rectal neoplasms, Preoperative radiotherapy, Evidence-based medicine, Patterns of care
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