|
KMID : 0362919930110020369
|
|
Journal of the Korean Society for Therapeutic Radiology and Oncology
1993 Volume.11 No. 2 p.369 ~ p.376
|
|
|
Cancinoma of Uterine Cervix Treated with High Dose Rate Intracavitary Irradiation : 1. Patterns of Failure
|
|
Kim Ok-Bae
Choi Tae-Jin
Kim Jin-Hee
Lee Ho-Jun
Kim Yeung-Ae
Suh Young-Wook
Lee Tae-Sung
Cha Soon-Do
|
|
|
Abstract
|
|
|
226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July, 1988 to May, 1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700∼4500 cGy) and boost parametrial doses(for a total of 4500∼6300 cGy) with midline shill(4×10 cm), and combined with intracavitary irradiation irradiation(5700∼7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37(16.4%), stage ⅡA 91 (40.3%), Stage ⅡB 58(25.7%), stage Ⅲ 32(13.8%), stage IV 8 (3.5%).
The overall failure rate was 23.9%(54 patients). The failure rate increased as a function of stage from 13.5% in stage 1B to 15.4% in stage ⅡA, 25.9% in stage ⅡB, 46.9% in stage Ⅲ, and 62.5% in stage Ⅳ. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure, 28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor.
The mean medial paracervical(point A) doses were 6700 cGy in stage ⅡB, 7200 cGy in stage ⅡA, 7450 cGy in stage ⅡB, 7600 cGy in stage Ⅲ and 8100 cGy in stage Ⅳ. The medial paracevical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, ⅡA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple Increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.
|
|
|
KEYWORD
|
|
|
Cervix, High dose rate, Brachytherapy, Patterns of failure
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|