Treatment Patterns and Decision Drivers in Chinese Patients with Locally Advanced Cervical Cancer: Results from a National Physician Survey

INTRODUCTION: Cervical cancer (CC) is the fourth-most common and lethal cancer in women worldwide, with ~ 23% of cases in Chinese patients. We sought to characterize real-world treatment patterns and decision drivers for locally advanced CC (LACC) in China. METHODS: We conducted a cross-sectional, 3-phase survey (quantitative development, cognitive, and quantitative interviews) of 360 physicians across 21 cities in China. Primary outcomes included treatment patterns and decision drivers for Chinese patients with LACC. Cancer stage was reported per International Federation of Gynecology and Obstetrics (FIGO) 2018. RESULTS: Respondents were gynecologists (55.6%), radiation oncologists (36.1%), and medical oncologists (8.3%), who reported 67.7% patients had LACC (stage IB3-IVA). Treatment patterns varied by stage: chemoradiotherapy (CRT) alone was used by 18.1%, 42.2%, and 52.1% of respondents for stages IB3-IIA2, IIB, and III-IVA CC, respectively, with surgery-based treatment used by 67.1%, 42.0%, and 26.6% of respondents. Among patients with LACC receiving concurrent CRT, 57.7% received external-beam radiotherapy (EBRT) plus brachytherapy (BT). The most important LACC treatment decision drivers were treatment efficacy (91.7%), CC stage (89.7%), and safety (88.6%). Only 63.9% reported that both EBRT and BT could be performed at their hospitals. Radiotherapy-related issues were reported as the top unmet medical need by 66.4%. CONCLUSION: There is a significant LACC burden among female patients in China, and deviations from guideline-concordant concurrent CRT. Addressing implementation gaps in concurrent CRT adoption requires improved radiotherapy access, greater multidisciplinary team use, guideline-aligned quality control, enhanced physician and patient education, and improved affordability. Future research should incorporate patient perspectives to improve patient-centered care and outcomes.