title: Practice patterns of adjuvant therapy for intermediate/high recurrence risk cervical cancer patients in Japan.
abstract: OBJECTIVE
  Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan.
  
  
  METHODS
  A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer.
  
  
  RESULTS
  Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%).
  
  
  CONCLUSIONS
  This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.|Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Yuji
authors.identifier: http://orcid.org/0000-0003-1633-5385
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Akiko
authors.identifier: http://orcid.org/0000-0003-1279-4971
authors.initials: A
authors.lastname: Furusawa
authors.affiliation: Department of Obstetrics and Gynecology, NTT Medical Center Tokyo, Tokyo, Japan. ryokitagawajp@yahoo.co.jp.
authors.forename: Ryo
authors.identifier: http://orcid.org/0000-0003-3679-8168
authors.initials: R
authors.lastname: Kitagawa
authors.affiliation: Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Aya
authors.identifier: http://orcid.org/0000-0002-7134-7437
authors.initials: A
authors.lastname: Tokinaga
authors.affiliation: Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
authors.forename: Fuminori
authors.identifier: http://orcid.org/0000-0002-0437-0979
authors.initials: F
authors.lastname: Ito
authors.affiliation: Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Masayo
authors.identifier: http://orcid.org/0000-0002-1660-1834
authors.initials: M
authors.lastname: Ukita
authors.affiliation: Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Hidetaka
authors.identifier: http://orcid.org/0000-0002-2742-5282
authors.initials: H
authors.lastname: Nomura
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Wataru
authors.identifier: http://orcid.org/0000-0003-3925-6057
authors.initials: W
authors.lastname: Yamagami
authors.affiliation: Department of Obstetrics and Gynecology, Jikei University Kashiwa Hospital, Kashiwa, Japan.
authors.forename: Hiroshi
authors.identifier: http://orcid.org/0000-0002-8445-8558
authors.initials: H
authors.lastname: Tanabe
authors.affiliation: Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Mikio
authors.identifier: http://orcid.org/0000-0002-7496-3518
authors.initials: M
authors.lastname: Mikami
authors.affiliation: Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Nobuo
authors.identifier: http://orcid.org/0000-0003-2521-039X
authors.initials: N
authors.lastname: Yaegashi
mesh_terms: D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000628:therapy*
keywords: Adjuvant Therapy; Drug Therapy; Radiation; Uterine Cervical Neoplasms