Patterns of failure in carcinoma of the uterine cervix treated with definitive radiotherapy alone.
The purpose of this retrospective study was to evaluate the patterns of failure for the patients treated with definitive radiotherapy, and to discuss future treatment strategies for the uterine cervical cancer. From 1986 to 1995, 177 patients with stages I-III cervical cancer treated with a combination of two-axial conformal radiotherapy and radium brachytherapy were analyzed. The first treatment failures were pelvic failure in 11%, and distant metastases (DM) in 16% of the 177 patients. Paraaortic lymph nodes (PAN) were the most frequently metastatic regions (71%). In the pelvic control group, DM were in 6% of patients for stages I-II, and in 32% of patients for stage III. In the pelvic failure group, DM were in 75% of patients for stages I-II, and in 19% of patients for stage III. In stages I-II, the DM rate was significantly correlated with pelvic tumor control. However, there was no correlation in stage III. To improve survival, it is important to increase the pelvic tumor control rate for patients with stage I-II, and to increase the pelvic tumor and metastatic control rate in stage III. Additional treatments such as chemotherapy and/or PAN irradiation using conformal radiotherapy are required in stages I-II with locally bulky tumor and in stage III.
Sasaoka
M
M
Department of Radiation Oncology, Aichi Cancer Center, Aichi, Japan.
Fuwa
N
N
Asano
A
A
Matsumoto
A
A
Katou
E
E
Ito
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D016019:Survival Analysis; D017211:Treatment Failure; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*