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KMID : 0362919960140040317
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Journal of the Korean Society for Therapeutic Radiology and Oncology
1996 Volume.14 No. 4 p.317 ~ p.322
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Radiotherapy Results of Carcinoma of Cervix with positive Resection Margin
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Huh Seung-Jae
Kim Won-Dong
Wu Hong-Gyun
Kim Dae-Yong
Ha Sung-Whan
Ahn Yong-Chan
Kim Il-Han
Park Charn-Il
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Abstract
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Purpose: Patients with cervical cancer who have positive resection margins after radical hysterectomy are at increased risk for local recurrence. The results of postoperative pelvic radiotherapy for cervix cancer with positive resection margins were analyzed to evaluated the role of radiotherapy.
Materials and Methods: Between 1979 and 1992, 60 patients of cervix carcinoma were treated with postoperative radiotherapy after radical hysterectomy because of positive vaginal(48 patients) or parametrial resection margins(12 patients). Patients were treated with external beam radiation therapy(EBRT) alone (12 patients) or EBRT plus vaginal ovoid irradiation (VOI) (48 patients). The median follow-up period was 5 months.
Results: The 5-year actuarial disease free and overall survival rates for all patients were 75.2%, 84.1%, respectively. The overall recurrence rate was 23%(14/60). In 48 patients with positive vaginal resection margins, the pelvic recurrence was 8%(4/48). Distant metastasis was 15%(7/48). Of the 43 patients with positive vaginal resection margins treated with EBRT and VOI, recurrence rate was 21%(9/43), while recurrence rate was 40%(2/5) in the EBRT only treated group. In 12 patients with positive parametrial margins, three patients (25%) had distant metastases. The most significant prognostic factor was lymph node metastasis. Complications resulting from radiotherapy occurred at a rate of 32%(19/60) and grade III complications occurred in three patients (5%).
Conclusion: Postoperative radiotherapy can produce excellent pelvic control rates in patients with positive resection margins. In patients with positive vaginal margins, whole pelvic EBRT and BOI is recommended.
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KEYWORD
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Cervix Carcinoma, Resection Margin, Postoprative Radiotherapy
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