Article
Long term results of postoperative radiotherapy in carcinoma of the uterine cervix
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Published: | March 20, 2006 |
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Purpose: To analyze the results of adjuvant radiotherapy without chemotherapy in a large retrospective group of high-risk patients (pts.).
Material and methods: From 10/1986 to 12/2002, 120 pts. (median age: 46 years) with surgically treated carcinoma of the uterine cervix were postoperatively irradiated. 36/120 have been evaluated so far, complete data will be presented at the convention.
Results: Hysterectomy (R0 83%, R1 17%) had been combined with adnectomy in 66% and with lymphadenectomy in 89% of patients (histology: 80% squamous cell carcinoma, 17% adenocarcinoma, 3% combined). FIGO stages were distributed as follows: IA 3%, IB 56%, IIA 9%, and IIB 32%. N stage: N0 37%, N1 60%, Nx 3%. Grading: G1 6%, G2 37%, G3 54%, G4 3%. External radiotherapy was done with 50.4 Gy median dose to the pelvis. The paraaortic region was irradiated in 17% of pts. Brachytherapy was added in 68%. 5 year overall survival (OS) of all patients amounted to 49%. FIGO IA/B pts. had a 5 year OS of 67%, IIA/B pts. of 33%. Univariate and multivariate statistics will be presented. Late GIT toxicity grade I/II was recorded in 15% of pts., late bladder toxicity I/II in 15%, vaginal stenosis 0%, fistulae 0%.
Conclusions: Adjuvant radiotherapy is often used in pts. with high risk of recurrence. Recent results suggest that simultaneous radiochemotherapy might improve results. Our results from a large retrospective series show that postoperative radiotherapy alone can produce acceptable survival rates with low toxicity. It should be favored in pts. with reduced general condition or contraindications against chemotherapy.