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KMID : 0362919890070010059
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Journal of the Korean Society for Therapeutic Radiology and Oncology
1989 Volume.7 No. 1 p.59 ~ p.70
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Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix-Whole Pelvis Exlernal Irradiation end High-Dose-Rate Inlracavitary Irradiation
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Kim Myung-Se
Kim Kyung-Ae
Kim Sung-Kyu
Shin Sei-One
Lee Sung-Ho
Chang Jae-Chun
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Abstract
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Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that
more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease.
96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen
which is 500∼1000 cGy higher than other institution.
Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement.
Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication.
Patient´s age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk.
Even though dose of point A and rectum is 500∼1,000 cGy higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.
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KEYWORD
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Bowel complication, Cancer of the uterine cervix, External irradiation, High-dose-rate intracavitary irradiation
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