title: High-dose-rate intracavitary brachytherapy combined with external beam radiotherapy for stage IIIb adenocarcinoma of the uterine cervix in Japan: a multi-institutional study of Japanese Society of Therapeutic Radiology and Oncology 2006-2007 (study of JASTRO 2006-2007).
abstract: OBJECTIVE
  The current study was a retrospective questionnaire survey of stage IIIb adenocarcinoma of the uterine cervix treated with high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy in Japan aimed to investigate the optimal dose on the basis of the biological effective dose and prognostic factors.
  
  
  METHODS
  Between 1990 and 2000, 61 patients with stage IIIb adenocarcinoma of the uterine cervix underwent high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy in 19 major hospitals in Japan. This retrospective questionnaire survey was performed by mail including survey charts to be fulfilled by radiation oncologists in these 19 major hospital. Fifty had only adenocarcinoma components and 11 had adenosquamous cell carcinoma components. All patients were treated with high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy. Total biological effective dose (T-BED(10)) was calculated from the sum of the biological effective doses of the external beam radiation therapy and the intracavitary brachytherapy. Thirty-two patients underwent chemotherapy.
  
  
  RESULTS
  The 5-year overall survival rate of all patients was 20.2%. Stratified by total biological effective dose, the 5-year overall survival rate was 0% for T-BED(10) <75 Gy, 24.7% for T-BED(10) between 75 and 100 Gy and 0% for T-BED(10) >110 Gy (P = 0.15). Stratified by histopathology, the 5-year overall survival rate was 22.1% for adenocarcinoma and 13.6% for adenosquamous cell carcinoma (P = 0.43). Stratified by chemotherapy, the 5-year overall survival rate was 20.3% in patients who received chemotherapy and 20.4% in patients who did not receive chemotherapy (P = 0.96).
  
  
  CONCLUSIONS
  The 5-year overall survival rate of stage IIIb adenocarcinoma of the uterine cervix in this retrospective questionnaire survey was 20.2%. The optimal T-BED(10) and evident prognostic factors were not clear from this questionnaire survey.
authors.affiliation: Department of Radiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 2288-555, Japan. joe-n@hkg.odn.ne.jp
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Niibe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kenjo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kazumoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ogino
authors.forename: Kayoko
authors.initials: K
authors.lastname: Tsujino
authors.forename: Yoko
authors.initials: Y
authors.lastname: Harima
authors.forename: Takeo
authors.initials: T
authors.lastname: Takahashi
authors.forename: Akira
authors.initials: A
authors.lastname: Anbai
authors.forename: Emiko
authors.initials: E
authors.lastname: Tsuchida
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takemoto
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011159:Population Surveillance; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017211:Treatment Failure; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*