Radiotherapy for uterine cervical cancer: results of the 1995-1997 patterns of care process survey in Japan.
OBJECTIVE
The aim of this study is to establish Japanese national practice patterns for uterine cervical cancer patients who received radiotherapy without surgery.


METHODS
The Japanese Patterns of Care Study (JPCS) conducted a national survey of 73 institutions using two-stage cluster sampling, and collected specific information on 591 patients with uterine cervical cancer treated by radiotherapy without planned surgery between 1995 and 1997.


RESULTS
The median age of the patients was 70 years. Karnofsky performance status (KPS) was >/=90 for 37%. Most patients (95%) had histology of squamous cell carcinoma. Ten percent were stage I, 29% stage II, 48% stage III and 13% stage IVA. Photon beams of 10-14 MV were the most used for external beam radiotherapy (EBRT). The beam energy utilized varied significantly by institution strata. Midline block was used in approximately 70% of institutions. Intracavitary brachytherapy (ICBT) was performed in 77%. Institution strata correlated significantly with the ICBT application. The majority of patients (89%) were treated with high-dose-rate (HDR) ICBT. The median single point A dose of HDR-ICBT was 600 cGy. The median summated point A dose from EBRT and HDR-ICBT was 5800 cGy (range: 1196-8600). The median overall treatment time including ICBT was 49 days. Twenty-four percent of the patients received chemotherapy. Concurrent chemoradiation was performed in 5%.


CONCLUSIONS
The JPCS established the Japanese national practice patterns of care for uterine cervical cancer patients treated with radiotherapy without planned surgery between 1995 and 1997. This survey demonstrated that the institutional strata significantly affected several practice patterns.
Toita
Takafumi
T
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215 Japan. b983255@med.u-ryukyu.ac.jp
Nakamura
Katsumasa
K
Uno
Takashi
T
Kodaira
Takeshi
T
Shinoda
Atsunori
A
Ogawa
Kazuhiko
K
Mitsuhashi
Norio
N
Maebayashi
Katsuya
K
Kawaguchi
Atsuko
A
Inoue
Toshihiko
T
Teshima
Teruki
T
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017663:Peplomycin / Q000008:administration & dosage; D010818:Practice Patterns, Physicians'; D011879:Radiotherapy Dosage; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*
D001761:Bleomycin; D017663:Peplomycin; D005472:Fluorouracil