2003-2005 年日本宫颈癌患者放疗实践模式：治疗过程模式的变化趋势。

Patterns of radiotherapy practice for patients with cervical cancer in Japan, 2003-2005: changing trends in the pattern of care process.

机构信息

Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.

出版信息

Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):1506-13. doi: 10.1016/j.ijrobp.2011.10.013. Epub 2012 Jan 21.

DOI:10.1016/j.ijrobp.2011.10.013

PMID:22270160

Abstract

PURPOSE

The patterns of care study (PCS) of radiotherapy for cervical cancer in Japan over the last 10 years was reviewed.

METHODS AND MATERIALS

The Japanese PCS working group analyzed data from 1,200 patients (1995-1997, 591 patients; 1999-2001, 324 patients; 2003-2005, 285 patients) with cervical cancer treated with definitive radiotherapy in Japan.

RESULTS

Patients in the 2001-2003 survey were significantly younger than those in the 1999-2001 study (p < 0.0001). Histology, performance status, and International Federation of Gynecology and Obstetrics stage were not significantly different among the three survey periods. Use of combinations of chemotherapy has increased significantly during those periods (1995-1997, 24%; 1999-2001, 33%; 2003-2005, 54%; p < 0.0001). The ratio of patients receiving concurrent chemotherapy has also dramatically increased (1995-1997, 20%; 1999-2001, 54%; 2003-2005, 83%; p < 0.0001). As for external beam radiotherapy (EBRT), the application rate of four-field portals has greatly increased over the three survey periods (1995-1997, 2%; 1999-2001, 7%; 2003-2005, 21%; p < 0.0001). In addition, the use of an appropriate beam energy for EBRT has shown an increase (1995-1997, 67%; 1999-2001, 74%; 2003-2005, 81%; p = 0.064). As for intracavitary brachytherapy (ICBT), an iridium source has become increasingly popular (1995-1997, 27%; 1999-2001, 42%; 2003-2005, 84%; p < 0.0001). Among the three surveys, the ratio of patients receiving ICBT (1995-1997, 77%; 1999-2001, 82%; 2003-2005, 78%) has not changed. Although follow-up was inadequate in each survey, no significant survival differences were observed (p = 0.36), and rates of late Grade 3 or higher toxicity were significantly different (p = 0.016).

CONCLUSIONS

The Japanese PCS has monitored consistent improvements over the past 10 years in the application of chemotherapy, timing of chemotherapy, and EBRT methods. However, there is still room for improvement, especially in the clinical practice of ICBT.

摘要

目的

回顾过去 10 年日本宫颈癌放射治疗的模式研究（PCS）。

方法和材料

日本 PCS 工作组分析了 1200 例宫颈癌患者（1995-1997 年，591 例；1999-2001 年，324 例；2003-2005 年，285 例）接受根治性放疗的资料。

结果

2001-2003 年调查的患者明显比 1999-2001 年研究的患者年轻（p < 0.0001）。三期调查中，组织学、表现状态和国际妇产科联合会（FIGO）分期无显著差异。同期化疗联合应用显著增加（1995-1997 年，24%；1999-2001 年，33%；2003-2005 年，54%；p < 0.0001）。同期接受同步化疗的患者比例也明显增加（1995-1997 年，20%；1999-2001 年，54%；2003-2005 年，83%；p < 0.0001）。对于外照射放疗（EBRT），在三个调查期间，四野门的应用率大大增加（1995-1997 年，2%；1999-2001 年，7%；2003-2005 年，21%；p < 0.0001）。此外，EBRT 中合适射线能量的应用也有所增加（1995-1997 年，67%；1999-2001 年，74%；2003-2005 年，81%；p = 0.064）。对于腔内近距离放疗（ICBT），铱源越来越受欢迎（1995-1997 年，27%；1999-2001 年，42%；2003-2005 年，84%；p < 0.0001）。在这三个调查中，接受 ICBT 的患者比例（1995-1997 年，77%；1999-2001 年，82%；2003-2005 年，78%）没有变化。尽管在每个调查中随访都不充分，但没有观察到显著的生存差异（p = 0.36），晚期 3 级或更高毒性的发生率差异有统计学意义（p = 0.016）。