A Regional Cooperative Clinical Study of Radiotherapy for Cervical Cancer in East and South-East Asian Countries

Purpose \nRadiotherapy differed widely in east and south-east Asia because of technical, cultural, and socio-economic differences. With the purpose of standardizing radiotherapy for cervical cancer in the region, an international clinical study was conducted. \nMaterials and methods \nEleven institutions in eight Asian countries participated in the study. Between 1996 and 1998, 210 patients with stage IIIB cervical cancer were enrolled. Patients were treated with a combination of external beam radiotherapy (total dose, 50 Gy) and either high-dose-rate (HDR) or low-dose-rate (LDR) intracavitary brachytherapy (ICBT) according to the institutional practice. The planned point A dose was 20-28 Gy/4 fractions for HDR-ICBT and 30-40 Gy/1-2 fractions for LDR-ICBT. \nResults \nHundred patients were treated with HDR-ICBT and 110 were treated with LDR-ICBT. The ICBT doses actually delivered to point A ranged widely: 12-32 Gy in the HDR group and 26-52.7 Gy in the LDR group. The 5-year follow-up rate among the countries differed greatly, from 29% to 100%. The 5-year major complication rates were 6% in the HDR group and 10% in the LDR group. The 5-year overall survival rates were 51.1% in the HDR group and 57.5% in the LDR group. \nConclusions \nAlthough there were several problems with treatment compliance and patients follow-up, the study suggests that the protocols provided favorable outcomes with acceptable rates of late complications in the treatment of advanced cervical cancer in east and south-east Asia. \nKeywords: Cervical cancer; Radiotherapy; Developing country; International clinical study; East and south-east Asiajournal articl