Radiotherapy for Uterine Cervical Cancer: Results of the 1995–1997 Patterns of Care Process Survey in Japan

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:Themedian 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 beamsof 10–14MVwere themost 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 ICBTapplication. 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. Concurren