Comparison of the Result of Radiation Alone and Chemoradiation in Cervical Cancer

Park, In Kyu; Kim, Jae Cheol

Abstract

PURPOSE: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication.
MATERIALS AND METHODS
A retrospective analysis of 135cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18(13.3%) stage IB, 7(5.2%) stage IIA, 97(71.9%) stage IIB, and 9(6.7%) stage IIIB.
RESULTS
A complete response was noted in 51 patients (91.1% of the radiation alone group, and 68 patinets(86.1%) of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was 73.3%. According to stage, overall survival rates at 5 years were 88.9% in stage IB, 85.7% in stage IIA, 73.8% in stage IIB, and 37.5 in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were 81.9% in the radiation alone group, 67.0% in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were 70.4% in the radiation alone group, 68.5% in the chemoradiation group(p=0.85). Locoregional control rates at 5 years were 76.1% in the radiation alone group, 73.8% in the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were 83.9% in the radiation alone group, 90.3% in the chemoradiation group(p=0.59). Treatment-related bone marrow suppressions were noted in 3 (5.4%) patients of the radiation alone group, 14 patients (17.7%) of the chemoradiation group (p<0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group and 10 patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesical, rectal, and small bowel complications between the two groups.
CONCLUSION
No statistical differences was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure, but the incidence of bone marrow suppression was higher in the chemoradiation group.