Toita Takafumi, Nakamura Katsumasa, Uno Takashi, Kodaira Takeshi, Shinoda Atsunori, Ogawa Kazuhiko, Mitsuhashi Norio, Maebayashi Katsuya, Kawaguchi Atsuko, Inoue Toshihiko, Teshima Teruki
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215 Japan.
Jpn J Clin Oncol. 2005 Mar;35(3):139-48. doi: 10.1093/jjco/hyi047.
The aim of this study is to establish Japanese national practice patterns for uterine cervical cancer patients who received radiotherapy without surgery.
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.
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 approximately 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%.
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.
本研究旨在确立日本未接受手术治疗的子宫颈癌患者的全国性治疗模式。
日本治疗模式研究（JPCS）采用两阶段整群抽样法对73家机构进行了全国性调查，收集了1995年至1997年间591例未接受计划性手术、接受放射治疗的子宫颈癌患者的具体信息。
患者的中位年龄为70岁。37%的患者卡氏功能状态（KPS）≥90。大多数患者（95%）为鳞状细胞癌组织学类型。10%为I期，29%为II期，48%为III期，13%为IVA期。10 - 14 MV的光子束是体外放射治疗（EBRT）最常用的。各机构层所使用的束能量差异显著。约70%的机构使用了中线挡铅。77%的患者接受了腔内近距离放射治疗（ICBT）。机构层与ICBT的应用显著相关。大多数患者（89%）接受了高剂量率（HDR）ICBT治疗。HDR-ICBT的中位单点A点剂量为600 cGy。EBRT和HDR-ICBT的中位总A点剂量为5800 cGy（范围：1196 - 8600）。包括ICBT在内的中位总治疗时间为49天。24%的患者接受了化疗。5%的患者接受了同步放化疗。
JPCS确立了1995年至1997年间日本未接受计划性手术、接受放射治疗的子宫颈癌患者的全国性治疗模式。本次调查表明，机构层对多种治疗模式有显著影响。
