The Results of Curative Radiotherapy for Carcinoma of Uterine Cervix

Kang, Ki Mun; Ryu, Mi Ryeong; Chang, Gee Young; Suh, Tae Suk; Yoon, Sei Chul; Bahk, Yong Whee; Shinn, Kyung Sub; Namkoong, Sung Eun; Kim, Seung Jo

Abstract

Thi is a retrospective analysis of 135 patients with invasive carcinoma of the uterine cervix treated with curative radiotherapy from March 1983 through October 1989 at the Department of Therapeutic Radiology, Kang-Nam St. Mary's Hospital. Among them, 78 patients received radiotherapy alone and 42 patients treated with neoadjuvant chemotherapy followed by radiotherapy and 15 patients were lost to follow up. All patients had follow up from 2 to 106 months (median; 62 months). Age of the patients ranged from 32 to 79 years at presentation (median; 59 years). According to FIGO classification, there were 20(16.7%) in stage IB, 19(15.8%) in stage IIA, 49 (40.8) in stage IIB, 5(4.2%) in stage IIIA, 13(10.8%) in stage in stage IIIB, 14(11.7%) in stage IVA. The pathological classification showed 96(80.0%) squamous cell carcinomas, 5 (4.2%) adenocarcinomas and 19(15.8%) proven by cytology. The overall 5-year survival rates was 50.8%, and the 3%, respectively. The 5-year survival rates was noted 51.2% of radiotherapy alone and 50.4% of neoadjuvant chemotherapy followed by radiotherapy. The overall failure rate was 18.3%(22/120) including 11.7% (14/120) locoregional failure, 5.8% (7/120) distant metastasis and 0.8% (1/120) locoreginal failure with distant metastasis. Treatment failure rates by the stages were 15% (3/20) in stage IB, 10.5% (2/19) in stage IIA, 10.2%(5/49) in stage IIB, 20%(1/5) in stage IIA, 61.5%(8/13) in stage IIB, and 28.6%(4/14) in stage IVA. The overall complication rate was 34.2%(41/120), including wet desquamation 7.5%(9/120), diarrhea 6.7%(8/120), radiation proctitis 5.8%(7/120) in decreasing order. A multivariate analysis of factors influencing the survival showed patient age (p<0.0291), FIGO stage(p<0.0001), Karnofsky perfomance status(p<0.0043), initial hemoglobin level(p<0.0001), and intracvitary radiation(p<0.0004), but no significancy in histology(p<0.29) and treatment method(p<0.87).