Long-term results of proton beam therapy for carcinoma of the uterine cervix.
OBJECTIVE
To determine the role of proton therapy in patients with carcinoma of the uterine cervix.


METHODS
Between 1983 and 1991, 25 patients with squamous cell carcinoma of the uterine cervix (stages IIB-IVA) were treated with a curative intent by external photon irradiation to the pelvis, followed by proton irradiation to the primary tumor, delivering a median total tumor dose of 86 Gy (range 71 Gy/26 Fr-101 Gy/46 Fr), and were followed for a median period of 139 months (range 11-184 months).


RESULTS
Ten-year overall survival rates for stages IIB and IIIB/IVA patients were 89% and 40%, respectively. Five-year local control rates for stages IIB and IIIB/IVA patients were 100% and 61%, respectively. Four percent of patients experienced severe (Grade 4 or more) late complications in the intestine or urinary bladder at 5 years.


CONCLUSIONS
External photon and proton therapy is effective for those who are not eligible for intracavitary irradiation, and who otherwise have a poor prognosis. The results show that tumor control, survival, and morbidity are similar to those after conventional therapy.
Kagei
Kenji
K
Proton Medical Research Center, University Hospital, University of Tsukuba, Ibaraki, Japan. kkagei@md.tsukaba.ac.jp
Tokuuye
Koichi
K
Okumura
Toshiyuki
T
Ohara
Kiyoshi
K
Shioyama
Yoshiyuki
Y
Sugahara
Shinji
S
Akine
Yasuyuki
Y
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003092:Colitis / Q000209:etiology; D003556:Cystitis / Q000209:etiology; D019583:Dose Fractionation, Radiation; D004751:Enteritis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008875:Middle Aged; D017785:Photons / Q000009:adverse effects / Q000627:therapeutic use*; D011832:Radiation Injuries / Q000209:etiology; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D011880:Radiotherapy Planning, Computer-Assisted; D015996:Survival Rate; D017356:Synchrotrons; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy*
D003037:Cobalt Radioisotopes