Long-term follow-up results of irradiation alone or combined with surgery in stage I-IV carcinoma of the uterine cervix.
OBJECTIVE
Evaluation of side effects and prognostic factors for survival in cervical carcinoma treated with radiation therapy +/- surgery.


METHODS
From January 1986 to June 1995 277 female patients with cervical carcinoma were treated by irradiation in the Department of Radiation Oncology of the University of Münster. Out of them 224 patients were evaluable for clinical features. 20 of them did not undergo complete radiation series and 14 patients received irradiation for recurrent disease, therefore 190 patients (n = 103 pts. with primary irradiation, n = 87 pts. with postoperative irradiation) were analyzed for survival/therapeutic features.


RESULTS
5-year-disease-free survival rates after primary irradiation: (FIGO I number of patients too small); FIGO II (n = 33 pts.) 52%; FIGO III (n = 44 pts.) 39.5%; FIGO IV (n = 18 pts.) 26%. 5-year-survival rates after postoperative irradiation: pT1 (n = 43 pts.) 87.4%; pT2 (n = 37 pts.) 47%. As significant prognostic factors for disease specific survival after irradiation alone the hemoglobin bloodlevel at the beginning of radiation therapy, tumor stage according to FIGO, tumor size and irradiation of the paraaortic region were revealed. As significant prognostic factors for disease free survival after postoperative irradiation were seen: interval between surgery and the beginning of radiation therapy, tumor invasion of parametria, postoperative stage, involvement of lymph nodes and lymph-/hemangiosis. The documented side effects among all patients corresponded to data found in literature.


CONCLUSIONS
Prognostic factors for disease free survival in our patients corresponded to the results of other studies. Acute and chronic side effects after irradiation were within the usual range. Especially in case of additional irradiation of the paraaortic region we could not find an accumulation of side effects. An elevation of disease free survival rates in patients with cervical carcinoma probably could be obtained by improving positional techniques for irradiation or changing fractionation schedules.
Reinartz
G
G
Dept. of Radiation Oncology, University of Münster. gareina@uni-muenster.de
Bartsch
S
S
Willich
N
N
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery