National survey of high-dose rate brachytherapy for uterine cervical cancer

In order to clarify the current status of treatment policies and treatment technique of high-dose rate brachytherapy practice for cervical cancer in Japan, national survey was performed in 2001. The questionnaire was sent to 215 institutions holding high and medium dose rate Remote Afterloading System (RALS), and 199 (93%) responses were received. Of these responders, 175 performed typical brachytherapy with tandem and ovoid for a total of 2,007 patients with carcinoma of the cervix in 2000. There was a wide variant in the doses used. The median external beam radiotherapy (EBRT) dose was 50 Gy and 50 Gy and the median high dose rate (HDR) dose was 25 Gy and 24 Gy for early and advanced cancers, respectively. Brachytherapy was performed weekly by 138 (82%) institutions, and twice a week by 31 (18%) institutions. The median brachytherapy dose per fraction was 6 Gy for early and advanced cancer in the case of weekly brachytherapy. On the other hand, that dose was 5 Gy in the case of twice a week. The median total treatment time was 6.5 weeks and 7 weeks for early and advanced cancers, respectively. This retrospective survey showed the current brachytherapy practice pattern in the treatment of cervical cancer in Japan. There was a variation in the brachytherapy practice pattern. We should discuss with each other about the dose evaluation method for reference volume and reference point. (author)