Long term follow-up results of high-dose rate remote afterloading intracavitary radiation therapy for carcinoma of the uterine cervix.
OBJECTIVE
High-dose rate remote afterloading intracavitary radiation therapy (HDR) has been used as more safety system by the dose calculation using computer system before treatment and dose monitoring system using semiconductor dosimeter (ICD-5). This study shows our long-term follow-up results concerning survival, prognostic factor and late complications.


METHODS
Between August 1978 and December 1982, a total of 200 patients with carcinoma of the intact uterine cervix were treated using HDR. According to the staging system of UICC (1987), 8 patients were classified into Stage Ia, 22 Ib, 22 IIa, 53 IIb, 85 III, and 10 IV.


RESULTS
Cause specific five- and ten-year survival rates by Stage were 100%, 100% in Stage Ia, 90%, 90% in Stage Ib, 76%, 76% in Stage IIa, 86%, 84% in Stage IIb, 54%, 46% in Stage III and 20%, 20% in Stage IV, respectively. Significant prognostic factors by Cox's multivariate analysis were stage (p = 0.0001), the value of hemoglobin (p = 0.0005) and older age (p = 0.0114). Concerning stage classification the value of hemoglobin was the most important prognostic factor in Stage II (p = 0.032) and Stage III (p = 0.0015). Late complications requiring medical treatment after RALS developed in 24 patients (12%), i.e., rectum 14 (7), bladder 8 (4), small intestine 5 (3), sigmoid colon 1 (1). Severe complications requiring surgery were noted in 9 patients (5%).


CONCLUSIONS
HDR yields good results of survival with a low risk of severe side effects for the treatment of carcinoma of uterine cervix based on our long-term follow-up results.
Chatani
M
M
Department of Radiation Therapy, Center for Adult Diseases, Osaka.
Matayoshi
Y
Y
Masaki
N
N
Teshima
T
T
Inoue
T
T
D001918:Brachytherapy / Q000379:methods* / Q000706:statistics & numerical data; D002277:Carcinoma / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D013997:Time Factors; D017211:Treatment Failure; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*