TREATMENT PLANNING FOR ADENOCARCINOMA OF THE RECTUM AND SIGMOID - A PATTERNS OF CARE STUDY

Purpose: To conduct a study of the process of treatment planning and t reatment of adenocarcinoma of the rectum and sigmoid in the United Sta tes, and to compare survey results to consensus guidelines. Methods an d Materials: A consensus committee developed guidelines for the radiot herapeutic management of adenocarcinoma of the rectum and sigmoid, and also developed a survey form that was used to gather data to evaluate the practice patterns for patients treated in 1989 and 1990 against t he consensus guidelines. Seventy-three facilities were randomly select ed for site visits from the 1321 radiation therapy facilities in the U S: 21 academic, 26 hospital based, and 26 free standing, During the si te visits, the radiotherapy records were examined by the surveyor phys icist and radiation oncologist to extract and record the required data , Data collected included items related to treatment specific paramete rs, including treatment planning considerations, Analyses included str atification as to the types of institutions, academic, hospital based, or free standing. Results: For many treatment parameters there are di screpancies between the patterns of practice determined by the surveys and the consensus guidelines for radiotherapy treatment of adenocarci noma of the rectum and sigmoid, Significant differences in practice am ong the stratified institution types were found in only a few paramete rs. (C) 1997 Elsevier Science Inc.