Therapeutic Results of Postoperative Radiation Therapy for Uterine Cervical Cancer

Choi, Doo Ho; Hong, Seong Eon

Abstract

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients, 24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 patients). The actuarial overall and relapse free 5 year survival rate were 71.0%, 68.3% respectively. The survival rates by stage were 79.1% in stage I, and 61.2% in stage II. Treatment failure was noted in 18 of 64 patients (28.1%), locoregional failure in 8(12.5%), distant metastasis in 8(12.5%), paraaortic node metastasis in 1 and one patient had concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thickness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level, resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24(33.3%), 5000-5500 cGy+ICR 3/7(42.9%), 5000-5500 cGy external RT only group 3/33(9.1%). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose not improve results but only increases complication.