Patterns of radiotherapy practice for patients with cervical cancer (1999-2001): Patterns of Care Study in Japan
Patterns of radiotherapy practice for patients with cervical cancer (1999-2001): Patterns of Care Study in Japan
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DOI：
10.1016/j.ijrobp.2007.10.045
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发表时间：
2008-03-01
影响因子：
7
通讯作者：
Teshima, Teruki
中科院分区：
文献类型：
--
作者：
Toita, Takafumi;Kodaira, Takeshi;Teshima, Teruki
目的：探讨1999 ~ 2001年日本宫颈癌患者放射治疗的临床特点。方法与材料：日本护理模式研究（JPCS）工作组对68家机构进行了第三次外部审计调查，收集了324例接受明确放疗的宫颈癌患者的具体信息。结果：几乎所有患者（96%）均采用对位前后野全盆腔放疗（87%）。70%的患者采用中线阻滞。腔内近距离放射治疗（ICBT）占82%。大多数患者（89%）接受高剂量率（HDR） ICBT治疗。25%的病例对直肠和18%的病例对膀胱进行了危险器官剂量计算（ICRU 38）。只有3%的患者在ICBT应用器插入期间给予静脉清醒镇静。在接受HDR-ICBT治疗的病例中，A点（EBRT+ICBT）的中位总生物有效剂量为74 Gy（10）。不同阶段的总生物有效剂量无显著差异。中位总治疗时间为47天。17%的患者同时进行放化疗。结论：本研究描述了日本宫颈癌放疗实践的一般模式。虽然外部放疗方法似乎是合适的，但在ICBT实践中仍有改进的余地，例如预处理。观察到日本和美国的放射治疗总剂量有很大差异。(c) 2008爱思唯尔公司
Purpose: To describe the patterns of definitive radiotherapy practice for patients with uterine cervical cancer from 1999 to 2001 in Japan.Methods and Materials: The Japanese Patterns of Care Study (JPCS) working group conducted a third extramural audit survey of 68 institutions and collected specific information on 324 cervical cancer patients treated with definitive radiotherapy.Results: Almost all patients (96%) were treated with whole pelvic radiotherapy using opposing anteroposterior fields (87%). A midline block was used in 70% of the patients. Intracavitary brachytherapy (ICBT) was applied in 82% of cases. Most patients (89%) were treated with high-dose rate (HDR) ICBT. Calculation of doses to organs at risk (ICRU 38) was performed for rectum in 25% of cases and for bladder in 18% of cases. Only 3% of patients were given intravenous conscious sedation during ICBT applicator insertions. The median total biologically effective dose at point A (EBRT+ICBT) was 74 Gy(10) in cases treated with HDR-ICBT. There was no significant difference in total biologically effective dose between stages. The median overall treatment time was 47 days. Concurrent chemoradiation was applied in 17% of patients.Conclusions: This study describes the general patterns of radiotherapy practice for uterine cervical cancer in Japan. Although methods of external radiotherapy seemed to be appropriate, there was room for improvement in ICBT practice, such as pretreatment. A substantial difference in total radiotherapy dose between Japan and the United States was observed. (c) 2008 Elsevier Inc.