Postoperative radiotherapy for non-small-cell lung cancer: results of the 1999-2001 patterns of care study nationwide process survey in Japan.
To investigate the practice process of postoperative radiation therapy for non-small-cell lung cancer (NSCLC) in Japan. Between April 2002 and March 2004, the Patterns of Care Study conducted an extramural audit survey for 76 of 556 institutions using a stratified two-stage cluster sampling. Data on treatment process of 627 patients with NSCLC who received radiation therapy were collected. Ninety-nine (16%) patients received postoperative radiation therapy between 1999 and 2001 (median age, 65 years). Pathological stage was stage I in 8%, II in 17%, IIIA in 44%, and IIIB in 20%. The median field size was 9 cmx11 cm, and median total dose was 50 Gy. Photon energies of 6 MV or higher were used for 64 patients, whereas a cobalt-60 unit was used for five patients. Three-dimensional conformal treatment was used infrequently. Institutional stratification influenced several radiotherapy parameters such as photon energy and planning target volume. Smaller non-academic institutions provided worse quality of care. The study confirmed continuing variation in the practice of radiotherapy according to stratified institutions. Outdated equipment such as Cobalt-60 units was used, especially in non-academic institutions treating only a small number of patients per year.
Uno
Takashi
T
Department of Radiology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuou-ku, Chiba City, Chiba 260-8670, Japan. unotakas@faculty.chiba-u.jp
Sumi
Minako
M
Kihara
Ayaka
A
Numasaki
Hodaka
H
Kawakami
Hiroyuki
H
Ikeda
Hiroshi
H
Mitsumori
Michihide
M
Teshima
Teruki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011013:Pneumonectomy; D011159:Population Surveillance; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies