© 2005 Foundation for Promotion of Cancer Research
Radiotherapy for Uterine Cervical Cancer: Results of the 1995–1997 Patterns of Care Process Survey in Japan
1 Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, 2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 3 Department of Radiation Oncology, Chiba University Graduate School of Medicine, Chiba, 4 Department of Radiation Oncology, Aichi Cancer Center, Nagoya, 5 Department of Radiology, Nagano National Hospital, Nagano, 6 Department of Radiology, Tokyo Women's Medical University, Tokyo, 7 Department of Medical Physics and Engineering and 8 Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
For reprints and all correspondence: Takafumi Toita, Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215 Japan. E-mail: b983255{at}med.u-ryukyu.ac.jp
Received November 29, 2004; accepted January 19, 2005
Objective: The aim of this study is to establish Japanese national practice patterns for uterine cervical cancer patients who received radiotherapy without surgery.
Methods: The Japanese Patterns of Care Study (JPCS) conducted a national survey of 73 institutions using two-stage cluster sampling, and collected specific information on 591 patients with uterine cervical cancer treated by radiotherapy without planned surgery between 1995 and 1997.
Results: The median age of the patients was 70 years. Karnofsky performance status (KPS) was 
90 for 37%. Most patients (95%) had histology of squamous cell carcinoma. Ten percent were stage I, 29% stage II, 48% stage III and 13% stage IVA. Photon beams of 10–14 MV were the most used for external beam radiotherapy (EBRT). The beam energy utilized varied significantly by institution strata. Midline block was used in 
70% of institutions. Intracavitary brachytherapy (ICBT) was performed in 77%. Institution strata correlated significantly with the ICBT application. The majority of patients (89%) were treated with high-dose-rate (HDR) ICBT. The median single point A dose of HDR-ICBT was 600 cGy. The median summated point A dose from EBRT and HDR-ICBT was 5800 cGy (range: 1196–8600). The median overall treatment time including ICBT was 49 days. Twenty-four percent of the patients received chemotherapy. Concurrent chemoradiation was performed in 5%.
Conclusions: The JPCS established the Japanese national practice patterns of care for uterine cervical cancer patients treated with radiotherapy without planned surgery between 1995 and 1997. This survey demonstrated that the institutional strata significantly affected several practice patterns.
Key Words: cervical neoplasms • radiotherapy • Patterns of Care Study
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