Dose-response and failure pattern for bulky or barrel-shaped stage IB cervical cancer treated by combined photon irradiation and extrafascial hysterectomy

Journal Article · Sun Jan 01 04:00:00 EST 1989 · Cancer (Philadelphia); (United States)

DOI:https://doi.org/10.1002/1097-0142(19890101)63:1<70::AID-CNCR2820630112>3.0.CO;2-Q· OSTI ID:6497556

Maruyama, Y; van Nagell, J R; Yoneda, J; Donaldson, E; Gallion, H H; Higgins, R; Powell, D; Kryscio, R; Berner, B

From 1975 to 1987, 80 patients with bulky or barrel-shaped Stage IB cervical cancer were treated with preoperative irradiation and Cs-137 intracavitary implant therapy, before a planned extrafascial abdominal hysterectomy, using a consistent treatment policy. Of the hysterectomy specimens obtained, 37% were positive histologically at 89 +/- 2.3 days after the start of radiotherapy and at 4 to 6 weeks after the completion of radiation therapy. Sixty-three percent were negative after a total external and internal cervix irradiation dose of 9642 cGy at point T. The average point A dose contributed by intracavitary therapy was 2104 cGy. The survival rate at 5 years was 84%: At 10 years the survival rate was 78%. The failure pattern was analyzed for patients who had positive and negative specimens. The patients with positive specimens failed pelvically or pelvically and distantly. Patients with negative specimens failed in extrapelvic or distant metastatic sites. Preoperative radiotherapy led to excellent local and pelvic control of tumor, and the failures became predominantly distant metastases. The combined radiosurgical therapy was tolerated well and allowed surgical staging of disease. This permitted earlier and selective consideration of adjunctive therapy (i.e., paraaortic irradiation, chemotherapy, or chemoradiotherapy). The dose-response data give insight into the effects of photon radiotherapy on bulky or barrel Stage IB cervical cancers and correlate histologic status with failure pattern, outcome, and long-term survival.

• Research Organization: Univ. of Kentucky, Lexington (USA)
• OSTI ID: 6497556
• Journal Information: Cancer (Philadelphia); (United States), Journal Name: Cancer (Philadelphia); (United States) Vol. 63:1; ISSN CANCA
• Country of Publication: United States
• Language: English

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550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ALKALI METAL ISOTOPES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CESIUM 137
CESIUM ISOTOPES
DISEASES
DOSE-RESPONSE RELATIONSHIPS
FEMALE GENITALS
IMPLANTS
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PREGNANCY
RADIATION SOURCE IMPLANTS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SURGERY
SURVIVAL CURVES
THERAPY
UTERUS
YEARS LIVING RADIOISOTOPES