Young Ae Kim

Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea

External beam radiation therapy (EBRT) with concurrent chemotherapy followed by intracavitary brachytherapy is the standard treatment in locally advanced cervical cancer. This study examined the brachytherapy utilization rate and evaluated the effect of brachytherapy on survival in cervical cancer patients in Korea. In this study, data from the Korea Central Cancer Registry and Korean National Health Insurance Service and data on mortality from Statistics Korea were linked and used. Patients with other cancers, distant metastasis at diagnosis, or unknown stage or who underwent hysterectomy were excluded. A total of 12,721 cervical cancer patients were analyzed in this study. The brachytherapy utilization rate (%) was calculated as the proportion of patients who received brachytherapy among those who received curative EBRT. The brachytherapy utilization rate decreased from 84% in 2005 to 78% in 2013 (p<0.001). Brachytherapy utilization rates varied by region, ranging from 72% to 100% except for in Jeju Island, where the rate was 56%. The brachytherapy utilization rate was lower in patients older than 80 years; patients with localized disease, non-squamous cell carcinoma, or Charlson comorbidity index 3 or more; patients diagnosed after 2010; patients from certain regions; patients receiving medical aid; and patients who underwent gynecologic procedures. Multivariable Cox regression analysis showed that brachytherapy when added to curative EBRT was independently associated with better cancer-specific survival (CSS) and overall survival (OS) than curative EBRT only. The brachytherapy utilization rate decreased from 2005 to 2013 and varied by region in Korea. Brachytherapy use is independently associated with significantly higher CSS and OS in cervical cancer.

Experience of participating in national home-based medical care project for cancer patients with a temporary stoma: a qualitative study

This study aimed to explore the experiences of cancer patients with a temporary stoma who participated in a home-based healthcare service and to provide data to inform national health system policy development. This exploratory qualitative study involved 10 cancer patients with temporary stomas (five with rectal cancer, two with colorectal cancer, and three with ovarian cancer) recruited through purposive sampling in South Korea. In-depth, semi-structured online focus group interviews were conducted, and data were analyzed using thematic analysis. Four main themes were identified from the interview data: (1) adjusting with changes in daily life owing to the presence of a stoma, (2) skill building while participating in the project, (3) the need for a home-based medical care system during transitional care, and (4) the need for support in adapting to an ostomy. These themes included 12 subthemes. The findings highlight the need for ongoing health education and counseling services at a national level to support post-discharge self-care for cancer patients who had undergone ostomy. Patients with cancer discharged after colostomy surgery require continuous education and practical medical support, suggesting that home-based healthcare services may serve as a valuable alternative to conventional medical care.