1.Clinical Guideline for the Use of Biodegradable Rectal Spacers During Radiotherapy for Prostate Cancer
Hyun Ho HAN ; Jong Kyou KWON ; Do Kyung KIM ; Jin Hyung JEON ; Chan Woo WEE ; Jae Ho CHO ; Ji Hee JUNG ; A Young YOO ; Jae Young JOUNG ; Gee Hyun SONG ; Seung Ju LEE ; Won PARK ; Chan Kyo KIM ; Young Seok KIM ; Yeon Joo KIM ; Ah Ram CHANG ; Jae Sik KIM ; Sung Hwan BAE ; Byoung Kyu HAN ; Kang Su CHO
Journal of Urologic Oncology 2026;24(1):3-12
Purpose:
Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT.
Materials and Methods:
This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system.
Results:
Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised.
Conclusion
Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.
2.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
3.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
4.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.
5.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.
6.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
7.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
8.Pre-Treatment Perceived Social Support Is Associated With Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer: A Longitudinal Study
Joon Sung SHIN ; Sanghyup JUNG ; Geun Hui WON ; Sun Hyung LEE ; Jaehyun KIM ; Saim JUNG ; Chan-Woo YEOM ; Kwang-Min LEE ; Kyung-Lak SON ; Jang-il KIM ; Sook Young JEON ; Han-Byoel LEE ; Bong-Jin HAHM
Psychiatry Investigation 2025;22(4):424-434
Objective:
Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up.
Methods:
A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point.
Results:
Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010).
Conclusion
This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.
9.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.
10.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.

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