Radiotherapy Results of Uterine Cervix Cancer Stape IIB : Overall Survival, Prognostic Facters, Patterns of Failure and Late Complications

Kim, Eun Seog; Choi, Doo Ho; Huh, Seung Jae

Abstract

PURPOSE: Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications.
MATERIALS AND METHODS
This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months (mean 60 months) and age of patients ranged from 31 to 78 years at presentation (mean : 55 years).
RESULTS
Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight (16.8%) patients developed late rectal and urinary complications. There were tendency to increasing severity and frequency according to increased fractional dose and total (rectal and bladder) dose.
CONCLUSIONS
Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder doseaffected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.