A regional cooperative clinical study of radiotherapy for cervical cancer in east and south-east Asian countries.
OBJECTIVE
Radiotherapy differed widely in east and south-east Asia because of technical, cultural, and socio-economic differences. With the purpose of standardizing radiotherapy for cervical cancer in the region, an international clinical study was conducted.


METHODS
Eleven institutions in eight Asian countries participated in the study. Between 1996 and 1998, 210 patients with stage IIIB cervical cancer were enrolled. Patients were treated with a combination of external beam radiotherapy (total dose, 50Gy) and either high-dose-rate (HDR) or low-dose-rate (LDR) intracavitary brachytherapy (ICBT) according to the institutional practice. The planned point A dose was 20-28Gy/4 fractions for HDR-ICBT and 30-40Gy/1-2 fractions for LDR-ICBT.


RESULTS
Hundred patients were treated with HDR-ICBT and 110 were treated with LDR-ICBT. The ICBT doses actually delivered to point A ranged widely: 12-32Gy in the HDR group and 26-52.7Gy in the LDR group. The 5-year follow-up rate among the countries differed greatly, from 29% to 100%. The 5-year major complication rates were 6% in the HDR group and 10% in the LDR group. The 5-year overall survival rates were 51.1% in the HDR group and 57.5% in the LDR group.


CONCLUSIONS
Although there were several problems with treatment compliance and patients' follow-up, the study suggests that the protocols provided favorable outcomes with acceptable rates of late complications in the treatment of advanced cervical cancer in east and south-east Asia.
Nakano
Takashi
T
Department of Radiology and Radiation Oncology, Gunma University Graduate School of Medicine, Japan.
Kato
Shingo
S
Cao
Jianping
J
Zhou
Juying
J
Susworo
Raden
R
Supriana
Nana
N
Sato
Shinichiro
S
Ohno
Tatsuya
T
Suto
Hisao
H
Nakamura
Yuzuru
Y
Cho
Chul-Koo
CK
Ismail
Fuad B
FB
Calaguas
Miriam J C
MJ
de Los Reyes
Rey H
RH
Chansilpa
Yaowalak
Y
Thephamongkhol
Kullathom
K
Duc
Nguyen Ba
NB
Dung
To Anh
TA
Tsujii
Hirohiko
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001210:Asia, Southeastern; D001918:Brachytherapy / Q000379:methods; D005202:Asia, Eastern; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy*