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.