Japanese Journal of Clinical Oncology 34:99-103 (2004)
© 2004 Foundation for Promotion of Cancer Research
Postoperative Radiotherapy for Uterine Cervical Cancer: Results of the 19951997 Patterns of Care Process Survey in Japan
1 Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, 2 Department of Radiology, Tokyo Womens Medical University, Tokyo, 3 Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka, 4 Department of Medical Engineering, Osaka University Medical School, Osaka and 5 Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
Objective: To determine the average national practice of postoperative radiotherapy for uterine cervical cancer in Japan.
Methods: The Japanese Patterns of Care Study (PCS) reviewed the process of care employed for 455 uterine cervical cancer patients who were treated with surgery followed by postoperative radiotherapy (RT) during 19951997. Cases with missing data were excluded from calculations of percentage and significance for each of the surveyed items.
Results: According to FIGO stages, 198 patients (45%) were in stage I, 52 patients (12%) were in stage IIA, 146 patients (33%) were in stage IIB and 46 patients (10%) were in stage III/IVA. The most common surgical procedure among the patients was radical hysterectomy (73%). Three hundred and seventy patients (82%) were treated with external beam RT (ERT) alone, and 74 patients (17%) were treated with a combination of ERT and intracavitary RT (ICRT). A midline block was used for the pelvic field in 63 patients (14%). Only seven patients (2%) were treated with extended field ERT. Pelvic ERT was most often performed using AP-PA opposed fields for 431 patients (97%). A majority of the patients (312 patients, 70%) were treated with a total dose of 45.050.4 Gy for ERT. Chemotherapy (CT) was administered to 178 patients (40%), neoadjuvant preoperative CT was administered to 80 patients (22%) and concurrent CT with postoperative RT was administered to 29 patients (8%).
Conclusion: This PCS established the national practice average of postoperative RT for uterine cervical cancer. Follow-up studies need to be conducted to determine whether the observed differences in treatment processes affect outcomes.
+ For reprints and all correspondence: Takafumi Toita, Department of Radiology, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 9030215, Japan. E-mail: b983255{at}med.u-ryukyu.ac.jp
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