[Radiotherapy for cervical cancer: a multi-institutional comparison].

Radiotherapy has long been recognized as a successful treatment modality for all stages of carcinoma of the uterine cervix. In Japan, however, radiotherapists mainly have had to treat patients with far advanced cancer. Recently, however, the incidence of patients with early-stage cervical cancer who undergo surgery has increased, whereas that of patients with advanced disease has decreased significantly. As a result, the number of cervical cancer patients who visit radiotherapy departments has decreased significantly. Radiotherapy is useful for early cervical cancer, and radiotherapists need to make every effort to treat patients with early-stage cancer. Radiotherapy alone for cervical cancer consists mainly of external irradiation and intracavitary brachytherapy. Two modalities are used for brachytherapy, low dose rate and high dose rate. The latter modality, which was developed about three decades ago, spread rapidly and was improved in Japan and Europe. In 1983, the standard method of treating cervical cancer with Co-60 RALS was proposed by Arai et al. in Japan. Most institutes accepted this method with some modifications and have reported treatment results based on it. Currently, several modalities of radiotherapy are available for cervical cancer. JASTRO organized a study group to reconsider the treatment proposed by Arai et al. and reviewed the outcomes from nine institutions in Japan. Chemotherapy combined with radiotherapy previously was considered ineffective for cervical cancer. However, this February NCI suggested concomitant chemoradiotherapy was effective for improving the survival rates of most cervical cancer patients. This suggestion is introduced.