Patterns of care for patients with nasopharyngeal carcinoma (KROG 11-06) in South Korea.
OBJECTIVE
To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea.


METHODS
A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions.


RESULTS
Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose.


CONCLUSIONS
Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.
Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Soo Yoon
SY
Sung
Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Min Kyu
MK
Kang
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Chul Seung
CS
Kay
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Ki Chang
KC
Keum
Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
Sung Hwan
SH
Kim
Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Yeon-Sil
YS
Kim
Department of Radiation Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Won Taek
WT
Kim
Department of Radiation Oncology, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Ji-Yoon
JY
Kim
Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Jin-Hee
JH
Kim
Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Sung Ho
SH
Moon
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yong Chan
YC
Ahn
Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
Young Taek
YT
Oh
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Hong-Gyun
HG
Wu
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Chang-Geol
CG
Lee
Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
Woong-Ki
WK
Chung
Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Kwan Ho
KH
Cho
Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, Korea.
Moon-June
MJ
Cho
Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Korea.
Jin Hwa
JH
Choi
Korea; Nasopharyngeal neoplasms; Patterns of care; Radiotherapy