The Results of Radiation Treatment in Carcinoma of the Uterine Cervix

Lee, Myung Za; Kim, Jung Jin

Abstract

From July 1979 through March 1985, 112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-37. The treatment consisted of 3600rad-200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-00rad per day. Parametrial boost with 400-00rad was given in 60 patients. 2 intracavitary Cs-37 radiation using TAO applicator were done with 7-0 days interval. Total treatment times were 40-5 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899rad with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. 9(8%) had stage Ib, 14(12.5%) had stage IIa, 50(44.6%) had stage llb, 33(29.5%) had stage III, 6(5.4%) had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were 61.8% for the entire group, 84.6% for stage Ib, 77.8% for stage IIa, 56.7% for stage IIb, 60% for stage III, 33.3% for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in 7/18(38.9%) failure (=death) in contrast to 25/94 (26.5%) failure with dose over 800rad. RT dose to lateral parametrium (point B) below 6000rad yielded 20/63 (34.9%) failure compared to 10/49 (20.4%) failure with dose over 6000rad. Poor survival group of age were between 40-9 years with failure of 14/41 (34.1%). There was no increased failure rate below age of 40 with failure of 2/11 (13.9%). The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.