Patterns of radiotherapy practice for patients with cervical cancer (1999-2001): patterns of care study in Japan.
OBJECTIVE
To describe the patterns of definitive radiotherapy practice for patients with uterine cervical cancer from 1999 to 2001 in Japan.


METHODS
The Japanese Patterns of Care Study (JPCS) working group conducted a third extramural audit survey of 68 institutions and collected specific information on 324 cervical cancer patients treated with definitive radiotherapy.


RESULTS
Almost all patients (96%) were treated with whole pelvic radiotherapy using opposing anteroposterior fields (87%). A midline block was used in 70% of the patients. Intracavitary brachytherapy (ICBT) was applied in 82% of cases. Most patients (89%) were treated with high-dose rate (HDR) ICBT. Calculation of doses to organs at risk (ICRU 38) was performed for rectum in 25% of cases and for bladder in 18% of cases. Only 3% of patients were given intravenous conscious sedation during ICBT applicator insertions. The median total biologically effective dose at point A (EBRT+ICBT) was 74 Gy(10) in cases treated with HDR-ICBT. There was no significant difference in total biologically effective dose between stages. The median overall treatment time was 47 days. Concurrent chemoradiation was applied in 17% of patients.


CONCLUSIONS
This study describes the general patterns of radiotherapy practice for uterine cervical cancer in Japan. Although methods of external radiotherapy seemed to be appropriate, there was room for improvement in ICBT practice, such as pretreatment. A substantial difference in total radiotherapy dose between Japan and the United States was observed.
Toita
Takafumi
T
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara-cho, Okinawa, Japan. b983255@med.u-ryukyu.ac.jp
Kodaira
Takeshi
T
Shinoda
Atsunori
A
Uno
Takashi
T
Akino
Yuichi
Y
Mitsumori
Michihide
M
Teshima
Teruki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011832:Radiation Injuries / Q000517:prevention & control; D018787:Radiation Oncology / Q000592:standards*; D011879:Radiotherapy Dosage; D012007:Rectum / Q000528:radiation effects; D012062:Relative Biological Effectiveness; D014481:United States; D001743:Urinary Bladder / Q000528:radiation effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*