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J Korean Cancer Assoc > Volume 30(2); 1998 > Article
Journal of the Korean Cancer Association 1998;30(2): 214-224.
Inquiry about Management of Non-Small Cell Lung Cancer
Jae Young Park, Jung Suk Kim, Sin Kam, Sang Chul Chae, Jun Hee Won, Chang Ho Kim, Jae Chul Kim, Sang Hoon Jun, In Kyu Park, Tae Hoon Jung
1Department of Internal Medicine, School of Medicine, Kyungpook National University, Taegu, Korea.
2Department of Preventive Medicine, School of Medicine, Kyungpook National University, Taegu, Korea.
3Department of Therapeutic Radiology, School of Medicine, Kyungpook National University, Taegu, Korea.
4Department of Thoracic Surgery, School of Medicine, Kyungpook National University, Taegu, Korea.
In recent years there has been a considerable increase in the use of chemotherapy as an adjuvant to surgery, radical radiotherapy and in addition to best supportive care. However, the value of chemotherapy in improving survival is still unclear, despite more than 50 randomised trials addressing this question in the different stages of disease. This study was done to evaluate Korean doctors' personal management preference and their beliefs about prognosis in non-small celllung cancer(NSCLC).
A mail survey of Korean respirologists, thoracic surgeons, radiation oncologists, and medical oncologists was performed. Four cases of NSCLC were described and respondents were asked to give their treatment recommendations and to estimate the prognosis in each case.
After a complete resection for stage II NSCLC, 27% recommended no adjuvant treatment, 36% recommended radiotherapy, 18% recommended chemotherapy, and 19% recommended both radiotherapy and chemotherapy. After a complete resection for stage IIIA(N2) NSCLC, the vast majority of respondents recommended adjuvant therapy. For an asymptomatic patient with stage IIIB NSCLC, 5% recommended supportive care, 24% recommended radiotherapy, 16% recommended chemotherapy, and 54% recommended chemotherapy combined with radiotherapy. For a patient with stage IV NSCLC, 76% recommended chemotherapy with or without palliative radiotherapy. Doctors' treatment preference was significantly different by their speciliaty in a case with stage II, IIIA(N2), or IV NSCLC. Most respondents believed that chemotherapy would increase survival in NSCLC. Doctors' beliefs about the efficacy of treatment were strongly associated with their treatment recommendations.
Korean doctors generally preferred relatively aggressive management although their personal preferences varied widely. Team approach is important in deciding the treatment modality because doctors' treatment preference is different by their speciality.
Key words: Non-small cell lung cancer;Management;Surrogates
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