Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016.
Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016.
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DOI：
10.4143/crt.2017.459
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发表时间：
2018-07
影响因子：
4.6
通讯作者：
Kim Y
中科院分区：
文献类型：
--
作者：
Park HJ;Cho S;Kim Y
没有太多的研究评价了循证医学在直肠癌放疗（RT）中的采用和传播。我们的目的是分析机构特征和地理的差异，在采用循证护理直肠癌RT和影响因素，在韩国采用。使用韩国国民健康保险服务索赔数据库。本研究纳入了2005-2016年在同一机构接受根治性手术和辅助RT治疗的所有直肠癌患者。术前和术后3个月内的RT分别视为术前和术后RT。共有16，827名患者在83家机构接受治疗，并纳入分析。随着时间的推移，术前RT的使用大幅增加，从2005年的40.6%增加到2016年的84.2%。2006年，术前RT的比例（54.8%）超过术后RT的比例（45.2%）。然而，观察到了广泛的体制和区域差异。与高容量机构相比，低容量机构显示出术前RT的延迟采用和可变传播模式。釜山-蔚山-庆尚南道和江原道-做显示出比其他地区更慢的采用和更少的术前RT使用。我们证明，从2005年到2016年，全国直肠癌治疗中采用术前RT的情况逐渐稳定增加。观察到高交易量和低交易量机构之间的机构差异。
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. 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. 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. 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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