Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States

서지정보

· 발행기관 : 대한방사선종양학회
· 수록지 정보 : Radiation oncology journal / 26권 / 2호 / 83 ~ 90페이지
· 저자명 : 허원주, 최영민, 김정기, 이형식, 최석렬, 김일한

초록

Purpose: For the first time, a nationwide survey of the Patterns of Care Study (PCS) for the various radiotherapy
treatments of esophageal cancer was carried out in South Korea. In order to observe the different
parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed
in the United States (US) and Japan.
Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled
in the South Korean study. The patients received radiation theraphy (RT) from 1998 to 1999. In order to
compare these results with those from the United States, a published study by Suntharalingam, which included
414 patients [treated by Radiotherapy (RT)] from 59 institutions between 1996 and 1999 was chosen.
In order to compare the South Korean with the Japanese data, we choose two different studies. The results
published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed
from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between
1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients
were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001.
Results: The median age of enrolled patients was highest in the Japanese non-surgery group (71 years old).
The gender ratio was approximately 9：1 (male：female) in both the Korean and Japanese studies, whereas
females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous
cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and
Japanese studies (Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the
main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT
scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used
in the US study (9.5%), compared to the Korean (23.2%) and Japanese (39%) studies. The combination of
the three modalities (Surgery+RT+Chemotherapy) was performed least often in Korea (11.8%) compared to
the Japanese (49.5%) and US (32.8%) studies. Chemotherapy (89%) and chemotherapy with concurrent chemoradiotherapy
(97%) was most frequently used in the US study. Fluorouracil (5-FU) and Cisplatin were the most
preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study,
as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in
Japan, different median doses were delivered for the surgery (48 Gy) and non-surgery groups (60 Gy).
Conclusion: Although some aspects of the evaluation of esophageal cancer and its various treatment modalities
were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT
dose or technique, which includes the number of portals and energy beams.

참고자료

· 없음