RADIATION-THERAPY FOR RECTOSIGMOID AND RECTAL-CANCER - RESULTS OF THE1992-1994 PATTERNS OF CARE PROCESS SURVEY

Purpose: To determine the US national practice standards for patients with adenocarcinoma of the rectum treated in radiation oncology facili ties. Materials and Methods: A national survey of 57 institutions iden tified 507 eligible patients who received radiation therapy as a compo nent of their treatment for rectal cancer, A stratified two-stage clus ter sampling with simple random sampling at each stage for each stratu m was used and on-site surveys were performed, Results: Of the 507 pat ients, 378 (75%) received postoperative therapy, 110 (22%) received pr eoperative therapy, 17 (2%) received both preoperative and postoperati ve therapy, and less than 0.5% received intraoperative radiation alone . To more accurately assess the utilization of modern radiation techni ques as well as recommendations of the National Cancer Institute (NCI) -sponsored, randomized, postoperative, adjuvant combined modality ther apy rectal cancer trials into current practice, the analysis was limit ed to the 243 (48%) patients with tumor, node, and metastasis staging system classification T3 and/or N1-2MO disease who underwent conventio nal surgery with negative margins. Although only 7% were treated on a clinical trial, 90% received chemotherapy for a median of 21 weeks. Mo st were treated with modern radiation treatment techniques. In contras t, techniques to identify and help exclude the small bowel from the ra diation field were riot routinely used, Conclusion: Despite the fact t hat only 7% of patients with T3 and/or N1-2M0 disease were treated on a clinical trial, such trials appear to have resulted in a positive in fluence on the standard of practice within the oncology community. Alt hough there are still some deficiencies, the majority of these patient s received combined modality therapy and were treated with modern radi ation therapy techniques. (C) 1998 by American Society of Clinical Onc ology.