Key words Patterns of Care Study
Springer Online Journal Archives 1860-2000
Abstract Background. To improve the quality of radiation oncology in Japan, a Patterns of Care Study (PCS), a quality assurance program widely known in the United States, was introduced to Japan. In this study, the process, including work-up and treatment for uterine cervix cancer patients, was investigated to show nationwide variation by age. Methods. From July 1996 through February 1997, PCS extramural audits were performed for 29 institutions nationwide. Medical charts for 432 patients with uterine cervix cancer treated between 1992 and 1994 were reviewed based on the PCS data format used in the US. The processes of radiation therapy for these patients were compared in two age groups – those aged ≥75 years (n = 132) and those aged 〈75 years (n = 300). Results. There were significant differences by age group in medical background, indicating the fragility of the elderly and a relatively higher incidence of early-stage disease in the elderly by patient selection. Lower pelvic radiation doses were used for the elderly with advanced stage disease. There were no significant differences in unplanned breaks in external irradiation between the two age groups. Brachytherapy was used less commonly in the elderly group than in younger group (P = 0.0187). The dose range for brachytherapy did not show any significant difference between the two groups. Preliminary survival rates for the elderly were similar to those for the younger group. Conclusion. Radiation therapy was found to play an important role in the treatment of uterine cervix cancer in elderly as well as younger patients.
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