Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer
- Duke Univ. Medical Center, Durham, NC (USA)
From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.
- OSTI ID:
- 6715987
- Journal Information:
- Gynecologic Oncology; (USA), Vol. 37:3; ISSN 0090-8258
- Country of Publication:
- United States
- Language:
- English
Similar Records
Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy
Treatment of bulky stage IB and IIB cervical cancers with outpatient neutron brachytherapy, external pelvic radiation and extrafascial hysterectomy
Related Subjects
LYMPH NODES
METASTASES
NEOPLASMS
RADIOTHERAPY
UTERUS
PATIENTS
RADIATION INJURIES
SURGERY
SURVIVAL CURVES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DISEASES
FEMALE GENITALS
INJURIES
LYMPHATIC SYSTEM
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
550600 - Medicine