J Gynecol Oncol.  2016 May;27(3):e29. 10.3802/jgo.2016.27.e29.

Practice patterns of adjuvant therapy for intermediate/high recurrence risk cervical cancer patients in Japan

• Ikeda Y
• Furusawa A
• Kitagawa R
• Tokinaga A
• Ito F
• Ukita M
• Nomura H
• Yamagami W
• Tanabe H
• Mikami M
• Takeshima
• Yaegashi N

• KMID: 2363323
• DOI: http://doi.org/10.3802/jgo.2016.27.e29

Abstract

OBJECTIVE
Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan.
METHODS
A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer.
RESULTS
Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%).
CONCLUSION
This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.

Keyword

Adjuvant Therapy; Drug Therapy; Radiation; Uterine Cervical Neoplasms

MeSH Terms

Chemoradiotherapy, Adjuvant
Combined Modality Therapy
Female
Humans
Japan/epidemiology
Middle Aged
Neoplasm Recurrence, Local/prevention & control
*Practice Patterns, Physicians'/statistics & numerical data
Risk Assessment
Risk Factors
Surveys and Questionnaires
Uterine Cervical Neoplasms/radiotherapy/*therapy