A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer

Abstract

Background: The treatment outcome of advanced stage uterine cervical carcinoma remains unsatisfactory. In order to elaborate a novel trial within The Radiotherapy Cooperative Group (RCG) of the European Organization for Research and Treatment of Cancer (EORTC), we conducted a survey in 1997±1998 to determine the variability of pre-treatment assessment and treatment options. The variability of choosing surgery, de®ned radiation therapy techniques and chemotherapy are investigated, as well as the center's choices of future treatment strategies.Methods: Fifty two of 81 RCG centers from the RCG have participated in the survey. As one would expect, there is a large variation in the techniques used for pretreatment evaluation and treatment options. There is no`standard' for reporting acute and late side effects. Chemotherapy is used neither systematically nor uniformly, and some centers continue to use neadjuvant chemotherapy modalities.Results: Furthermore, the survey reveals that there is a strong demand for the reduction of overall treatment-time, for clinical investigation of novel combined modality treatment strategies, especially chemo±radiation therapy, and also for the use of new radiation sensitizers.Conclusion: We conclude that a more homogeneous approach to the pretreatment evaluation as well as treatment techniques is required in order to allow adequate quality control in any future trial of the RCG in the EORTC. q

Conséquences gynécologiques de la radiothérapie pelvienne

“…À titre indicatif, l'Annexe A rapporte la classification concernant la vulve, le vagin et l'utérus. Le glossaire, malgré un groupe de complications de grade 3 assez hétérogène et avantageusement divisé par certains en trois sous-groupes [18], s'est révélé fiable et reproductible et garde encore la préférence de nombreuses équipes [19]. En ce qui concerne la sphère gynécologique, l'échelle prend en compte plusieurs critères, variables selon les organes et qui seront très précisément gradés.…”

“…En pratique, les échelles SOMA-LENT restent encore peu utilisées (17 % de centres utilisent l'échelle pour l'évaluation des effets tardifs [19]), pénalisées par un défaut de validation, la mauvaise intégration du concept impact qualité de vie et la difficulté à employer les échelles telles qu'elles ont été publiées [2].…”

Tumor invasion depth is a useful pathologic assessment for predicting outcomes in cervical squamous cell carcinoma after neoadjuvant radiotherapy

“…Pathologic findings in resected specimens of cervical carcinoma can be the basis for extremely accurate assessment of the extent of disease [ 14 , 15 ]. However, as neoadjuvant RT and CCRT are applied in increasingly more cervical carcinoma patients, the need for a useful and easily applied pathologic assessment becomes increasingly critical.…”