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KMID : 0362919970150020129
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Journal of the Korean Society for Therapeutic Radiology and Oncology
1997 Volume.15 No. 2 p.129 ~ p.136
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Irradiation Alone in Stage IB, IIA, and IIB Cervix
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Ahn Sung-Ja
Choi Ho-Sun
Byun Ji-Soo
Chung Woong-Ki
Nah Byung-Sik
Nam Taek-Keun
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Abstract
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Purpose: We analyzed the survival and failure patterns of cervix cancer patients treated with irradiation alone to evaluate our treatment method and to compare with the others.
Methods and Materials: Two hundred and twenty cervical cancer patients, Stage ⅠB, ⅡA, and ⅡB who completed the planned treatment between May 1987 and December 1991 were analyzed retrospectively. The Stage ⅠB patients were restaged to the Stage ⅠB1 and ⅠB2 by the recently revised FIGO classification. Patients were treated with a combination of external irradiation and the intracavitary brachytherapy. Determination of the tumor control was done at the time of 6 months postirradiation. The follow-up time was ranged from 3 to 115 months and the mean was 62 months and the follow-up rate was 93.6%(206/220).
Results: The overall 5-year survival rate of Stage ⅠB1(N=50), ⅠB2(N=15), ⅡA(N=58), and ⅡB(N=97) was 94%, 87%, 69%, and 56%, respectively. In the univariate analysis of prognostic factors,stage(0.00), initial Hg level (p=0.00), initial TA-4(tumor-associated) antigen level(p=0.02), initial CEA level(p=0.02), barrel-shaped tumor(p=0.02), whole cervical involvement (0.00), pelvic lymphadenopathy(LAP) in CT(p=0.04), and post-irradiation adjuvant chemotherapy(p=0.00) were statistically significant in survival analysis. In a while, multivariate analysis showed that the stage was the most powerful prognostic indicator and the post-irradiation chemotherapy factor also showed the statistical significance. The overall local control rate was 81% and by the stage, 100% in Stage ⅠB1, 86.7% in Stage ⅠB2, 84.5% in Stage ⅡA, and 68.1% in Stage ⅡB, respectively. The overall tumor recurrence rate was 15.5%(27/174) and by the stage, 8%(4/50) in Stage ⅠB1, 0%(0/13) in Stage ⅠB2, 22.4%(11/49) in Stage ⅡA, and 19.4%(12/62) in Stage ⅡB, respectively.
Conclusions: We obtained the similar treatment results to the other´s ones in early stage cervical cancer patients. But in Stage ⅡB, the local control rate was lower than that of the other institutes and also the survival was poorer. So it seems to be necessary to reevaluate the treatment method in advanced cervical cancer patients.
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KEYWORD
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Survival, Failure patterns, Radiotherapy, Cervical cancer
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