TREATMENT SYSTEMS GUIDELINES FOR PRIMARY RECTAL-CANCER FROM THE 1996 PATTERNS OF CARE STUDY

Purpose: The Patterns of Care Rectal Cancer Committee was formed to de velop consensus recommendations for patients with adenocarcinoma of th e rectum limited to the pelvis. Methods and Materials: The Committee w as composed of a multidisciplinary group of oncologists, and clinical scenarios were chosen to address most of the major treatment controver sies in the combined modality treatment of rectal cancer. A literature search was then conducted and the major articles were identified, A m odified Delphi technique was used to arrive at consensus. Serial surve ys were conducted by distributing questionnaires to the Committee memb ers to consolidate expert opinion. Voting was conducted using a scorin g system and opinions were unified to the highest degree possible. Res ults: Consensus voting was performed for 4 clinical scenarios, Accepta bility ratings for treatment were grouped into 3 broad categories: not acceptable, acceptable, and most acceptable. Based on the treatment o ptions, a decision tree was developed that reflects the consensus of t he committee. Conclusion: These options may help guide treatment decis ions in rectal cancer. (C) 1998 Elsevier Science Inc.