High-dose rate intracavitary irradiation for carcinoma of the uterine cervix. The adverse effect of treatment prolongation.
OBJECTIVE
To investigate the adverse effect of treatment prolongation on the local control and survival of the cervical carcinoma of the uterus.


METHODS
Two hundred and sixteen patients with stage IIB and III cervical carcinoma treated with a combination of external radiation and high-dose rate (HDR) intracavitary irradiation between 1978 and 1989 were retrospectively studied. A multivariate analysis was used to determine the effect of treatment time on local control and survival.


RESULTS
Overall treatment time was the most highly significant factors for local control in the multivariate analysis (p = 0.0005). The 5-year cumulative relapse rates were significantly different with the treatment times 35 to 42 days: 9% versus 43 to 49 days: 19% versus 50 to 62 days: 42% (p = 0.001). The second most significant parameter was stage classification (p = 0.02). Concerning relapse-free survival, stage classification (p = 0.0001), overall treatment time (p = 0.0035) and hemoglobin level (p = 0.0174) were the 3 most important prognostic factors, although there was no relationship between treatment time and late complications.


CONCLUSIONS
These results suggest that prolongation of treatment time is associated with decreased local control and survival in patients treated with external radiation and HDR intracavitary irradiation.
Chatani
M
M
Department of Radiation Therapy, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka University Medical School, Japan.
Matayoshi
Y
Y
Masaki
N
N
Inoue
T
T
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011829:Radiation Dosage; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy*