[Pelvic wall recurrence of cervix carcinomas. Combined surgical-radio-chemotherapeutic procedure (CORCT)].
OBJECTIVE
The prognosis of patients with pelvic wall recurrences after primary therapy of cervical cancer is bad. In selected patients treated exclusively by surgery as primary therapy the 5-year survival rate was between 5 and 25%. Additionally the combination of operation and radiotherapy (CORT) improved the survival so far. We developed a new concept for the treatment of pelvic wall recurrences. This concept includes the combination of radical surgery, interstitial radiation and chemotheray--CORCT (combined operative- and radiochemotherapy).


METHODS
After radical surgery, interstitial HDR (Ir-192) brachytherapy in afterloading technique (2.5 Gy, 2 fractions/day in 5 days) was performed. Additionally a chemotherapy with cisplatin 25 mg/m2/day in 5 days and 5-fluorouracil 1000 mg/day in 5 days was applicated.


RESULTS
After combined operative- and radiotherapy 3 of 3 patients died after treatment within 8 months (median) because of distant metastases. After additive radiochemotherapy 3 of 4 patients had no evidence of disease (NED) after a follow-up period of 14 (12 to 30) months.


CONCLUSIONS
The first treatment results of the new designed combined operative- and radiochemotherapy concept (CORCT) led us to expect an improvement of the prognosis of patients with recurrences of cervical cancer at the pelvic wall.
Schulz-Wendtland
R
R
Gynäkologische Radiologie, Universität Erlangen-Nürnberg.
Krämer
S
S
Säbel
M
M
Heller
F
F
Keilholz
L
L
Jäger
W
W
Sauer
R
R
Lang
N
N
Bautz
W
W
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D010385:Pelvic Exenteration; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000628:therapy*
D002945:Cisplatin; D005472:Fluorouracil
Beckenwandrezidive des Zervixkarzinoms. Kombiniertes operativ-radiochemotherapeutisches Vorgehen (CORCT).