title: Treatment outcomes of patients with FIGO Stage I/II uterine cervical cancer treated with definitive radiotherapy: a multi-institutional retrospective research study.
abstract: The purpose of this study was to analyze the patterns of care and outcomes of patients with FIGO Stage I/II cervical cancer who underwent definitive radiotherapy (RT) at multiple Japanese institutions. The Japanese Radiation Oncology Study Group (JROSG) performed a questionnaire-based survey of their cervical cancer patients who were treated with definitive RT between January 2000 and December 2005. A total of 667 patients were entered in this study. Although half of the patients were considered suitable for definitive RT based on the clinical features of the tumor, about one-third of the patients were prescribed RT instead of surgery because of poor medical status. The RT schedule most frequently utilized was whole-pelvic field irradiation (WP) of 30 Gy/15 fractions followed by WP with midline block of 20 Gy/10 fractions, and high-dose-rate intracavitary brachytherapy (HDR-ICBT) of 24 Gy/4 fractions prescribed at point A. Chemotherapy was administered to 306 patients (46%). The most frequent regimen contained cisplatin (CDDP). The median follow-up time for all patients was 65 months (range, 2-135 months). The 5-year overall survival (OS), pelvic control (PC) and disease-free survival (DFS) rates for all patients were 78%, 90% and 69%, respectively. Tumor diameter and nodal status were significant prognostic indicators for OS, PC and DFS. Chemotherapy has potential for improving the OS and DFS of patients with bulky tumors, but not for non-bulky tumors. This study found that definitive RT for patients with Stage I/II cervical cancer achieved good survival outcomes.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Ariga
authors.affiliation: 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.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan; Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kazumoto
authors.affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kubozono
authors.affiliation: Department of Radiology, Saga University, Saga, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Tokumaru
authors.affiliation: Department of Radiology, Kurume University Hospital, Fukuoka, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Eto
authors.affiliation: Division of Radiation Oncology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Niibe
authors.affiliation: Department of Radiology, Sapporo Medical University, Sapporo, Japan.
authors.forename: Kensei
authors.initials: K
authors.lastname: Nakata
authors.affiliation: Department of Radiation Oncology, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan Department of Radiation Oncology, National Hospital Organization, Fukuyama Medical Center, Hiroshima, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneyasu
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nonoshita
authors.affiliation: Department of Diagnostic Radiology and Radiation Oncology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.affiliation: Gunma University Heavy Ion Medical Center, Gunma University, Gunma, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Aichi, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Iwata
authors.affiliation: Department of Radiology, Takii Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Harima
authors.affiliation: Department of Radiation Oncology, Miyagi Cancer Center, Miyagi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Radiation Oncology, St Marianna University, School of Medicine, Kanagawa, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Gomi
authors.affiliation: Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hodaka
authors.initials: H
authors.lastname: Numasaki
authors.affiliation: Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Teshima
authors.affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D010388:Pelvis / Q000528:radiation effects; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: cervical cancer; early stage; radiotherapy