[Combined treatment for locally advanced carcinoma of uterine cervix].
OBJECTIVE
To evaluate the feasibility of surgical management for patients with locally advanced carcinomas of uterine cervix after radical radiation therapy who were prone to develop central recurrence.


METHODS
These 40 patients were treated by combined pre-operative radiotherapy with dose at point A of > 70 Gy in 30 patients, 60 approximately 70 Gy in 7, 50 approximately 59 Gy in 2 and 44 Gy in 1. The interval between radiation and surgery was 1 - 6 weeks. Extrafascial hysterectomy was performed in 15 patients, subradical hysterectomy in 23 and radical hysterectomy with pelvic lymphadenectomy in 2 cases.


RESULTS
These patients have been followed up for 1 - 8 years with 2 died of other diseases and 12 died of cancer. Eighteen of the 26 survivors have been followed up for more than 5 years. The 3- and 5-year survival rates were 74.9% and 66.8%. Half of the death occurred within the first year after treatment. The 2-year death rate was 9/12 (75.0%). Three patients suffered from long term complications after the treatment, but all were cured by conservative management.


CONCLUSIONS
The combination of hysterectomy performed shortly after radical radiotherapy, ie, for patients with locally poor prognostic cervical carcinoma is reasonable and feasible.
Wang
Yixun
Y
Department of Gynecology, Provincial Cancer Hospital, Shenyang 110042, China.
Cao
Pinjiang
P
Zhang
Xin
X
Zeng
Qingdong
Q
D000328:Adult; D002584:Cervix Uteri; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*