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KMID : 0362919930110010149
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Journal of the Korean Society for Therapeutic Radiology and Oncology
1993 Volume.11 No. 1 p.149 ~ p.158
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The Results of Curative Radiotherapy for Carcinoma of Uterine Cervix
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Kang Ki-Mun
Ryu Mi-Ryeong
Jang Jee-Young
Suh Tae-Suk
Yoon Sei-Chul
Bahk Yong-Whee
Shinn Kyung-Sub
Namkoong Sung-Eun
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Abstract
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This 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 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 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 5-year survival rates by stage IB, ⅡA, ⅡB, ⅢA, ⅢB, ⅣA was 47.7%, 70.2%, 64.l%, 40.0%, 23.1%, 14.3%, respectively. The 5-year survival rates was noted 51.2% of radiotherapy alone and 50.4% of neoadjuyant 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) locoregional 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 ⅢA, 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%(8/127), 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 performance status(p<0.0043), initial hemoglobin level (p<0.0001), and intracavitary radiation(p<0.0004), but, no significancy in histology (p<0.29) and treatment method (p<0.87).
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KEYWORD
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Carcinoma of the uterine cervix, Curative radiotherapy, 5-year survival rate, Prognostic factors, Complications
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