CLINICAL EVALUATION OF POSTOPERATIVE RADIOTHERAPY FOR UTERINE CERVICAL CANCER

Abstract

Prognostic factors were reviewed in ninety-seven patients who underwent postoperative radiotherapy for uterine cervical cancer. All were treated by radical hysterectomy and pelvic lymphadenectomy. Indications for adjuvant radiotherapy included pelvic lymph node metastases, parametrial infiltration, vascular space involvement, a very close surgical margin, large primary lesion, adenocarcinoma/adenosquamous cell carcinoma, and uninvolved cervical tissue less than 3mm. They were given 6 MV X ray to the whole pelvic space (ninety-three cases treated with center split). The total dose was 30-60 Gy, and four received intracavitary irradiation. Thirty-seven patients were in clinical stage Ib, fifteen were in Ila, and forty-five were in IIb. The five-year survival rate was 80.4%, 78.8%, 84.1% and the overall rate was 81.5%. There were twenty-five recurrences, four recurrences at local sites, fi fteen at distant, and six at both. Of the recurrences, 60% were evident within 2 years, and the one-year survival rate from recurrences was 50%, which was comparatively good. As mentioned, postoperative radiotherapy for uterine cervical cancer appears to be effective. The prognostic factors included the number of pregnancy, abortion, histologic type, parametrial infiltration, pelvic lymph node metastases. Those with these prognostic factors were in the high risk group. It is necessary for those in the high risk group to receive some adjuvant therapy, such as chemotherapy.