Patterns of care in patients with cervical cancer 2012

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• 作者：S. Marnitz M.D. (1)
  C. Khler M.D. (2)
  A. Rauer (1)
  A. Schneider M.D. ; M.P.H. (2)
  V. Budach M.D. (1)
  A. Tsunoda M.D. (3)
  M. Mangler M.D. (2)
  
• 关键词：Cervical cancer ; Pattern of care ; Stage ; specific therapy ; Neoplasm staging ; Questionnaire ; Zervixkarzinom ; Therapiekonzepte ; Stadienabhngige Therapie ; Neoplasie ; Staging ; Umfrage
• 刊名：Strahlentherapie und Onkologie
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：190
• 期：1
• 页码：34-40
• 全文大小：
• 作者单位：S. Marnitz M.D. (1)
  C. Khler M.D. (2)
  A. Rauer (1)
  A. Schneider M.D., M.P.H. (2)
  V. Budach M.D. (1)
  A. Tsunoda M.D. (3)
  M. Mangler M.D. (2)
  
  1. Department of Radiooncology, CharitUniversittsmedizin, Augustenburger Platz 1, 13353, Berlin, Germany
  2. Department of Gynecology, CharitUniversittsmedizin, Berlin, Germany
  3. Department of Gynecologic Oncology, Barretos Cancer Centre, Barretos, Brazil
  
• ISSN：1439-099X

文摘

Background Platinum-based primary or adjuvant chemoradiation is the treatment of choice for patients with cervical cancer. However, despite national guidelines and international recommendations, many aspects in diagnosis, therapy, and follow-up of patients with cervical cancer are not based on valid data. Methods To evaluate the current patterns of care for patients with cervical cancer in Germany, a questionnaire with 25items was sent to 281radiooncologic departments and out-patient health care centers. Results The response rate was 51%. While 87% of institutions treat 05patients/year, 12% treat between 26 and 50 and only 1% treat more than 50patients/year. In 2011, the stage distribution of 1,706treated cervical cancers were IB1, IB2, IIA, IIB, IIIA/IIIB, and IV in 11, 12, 11, 22, 28, and 16%, respectively. CT (90%) and MRI (86%) are mainly used as staging procedures in contrast to PET-CT with 14%. Interestingly, 27% of institutions advocate surgical staging prior to chemoradiation. In the majority of departments 3D-based (70%) and intensity-modulated radiotherapy (76%) are used for percutaneous radiation, less frequently volumetric arc techniques (26%). Nearly all colleagues (99.3%) apply conventional fractioning of 1.8Gy for external-beam radiotherapy, in 19% combined with a simultaneous integrated boost. Cisplatinum mono is used as a radiosensitizer with 40mg/m2 weekly by 90% of radiooncologists. For boost application in the primary treatment, HDR (high-dose rate) brachytherapy is the dominant technique (84%). In patients after radical hysterectomy pT1B1/1B2, node negative and resection in sound margins adjuvant chemoradiation is applied due to the occurrence of 1 other risk factors in 167%. There is a broad spectrum of recommended primary treatment strategies in stages IIB and IVA. Conclusion Results of the survey underline the leading role but also differences in the use of chemoradiation in the treatment of cervical cancer patients in Germany.