[Significance of radiotherapy in the multidisciplinary treatment of gynecological malignant tumor].
Effectiveness of radiotherapy and measures for improvement of treatment were examined with regard to cervical cancer, endometrial cancer and ovarian cancer, for (1) adenocarcinoma, (2) metastatic cancer, and (3) cancer in persons of advanced age. I. (1) The prognosis of cervical adenocarcinoma is poor, but radiotherapy in combination with chemotherapy can be expected to be effective for the poorly differentiated type, metastasis to the lymph node, and deep cervical invasion. (2) Radiotherapy has limited effectiveness for endometrial cancer and needs to be employed in combination with chemotherapy for the poorly differentiated type adenocarcinoma, serous adenocarcinoma, deep uterine wall invasion, vascular invasion, and metastasis to the lymph nodes. (3) In regard to cervical cancer and endometrial cancer, identification and computation of the labeling index of S-phase cells by BrdU and examination of the localization and the changes in the appearance of tumor markers and oncogenic products showed radiosensitivity of adenocarcinoma to be poor. (4) For ovarian cancer, whole pelvic irradiation by the moving strip (MS) method in combination with chemotherapy showed satisfactory results for stage I and stage II cancers. For stage III cancers, the results was not satisfactory when the residual tumor was 2 cm or larger in size. Whole pelvic irradiation of 50-TDF or more is necessary in such cases. II. The prognosis in cases of metastasis to multiple pelvic lymph nodes is poor. For such cases, it is desirable to employ paraaortic irradiation in combination with chemotherapy, with consideration of the histologic type and progress of the cancer. III. The prognosis is poor in persons of advanced age of 70 or over.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Obstetrics and Gynecology, Hiroshima University School of Medicine.
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Fujiwara
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000367:Age Factors; D000818:Animals; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008207:Lymphatic Metastasis; D011788:Quality of Life; D011879:Radiotherapy Dosage; D051381:Rats; D015996:Survival Rate