RESUMEN
Forty seven patients with locally recurrent uterine cerival cancer after surgery were treated with radiation during the 6 year period from 1979 through 1984 at the Department of Therapeutic Radiology of Seoul National University Hospital. In 30 out of the 47 patients, recurrence was diagnosed within 2 years after surgery. Site of recurrence was vagina in 19 patients, vagina and parametrium in 21 patients and parametrium only in 7 patients. Complete tumor control was achieved in 35 patients (74.5%) ; the complete response rates were 94.7% (18/19( in vaginal recurrences, 57.1% (12/21) in combined vaginal and parametrial recurrences and 71.4% (5/7) in parametrial recurrences. Overall and disease free survival rates at 4 years were 55.2 and 50.1 percent, respectively, for entire group. Overall 4 year survival rates were 77.0% for vaginal recurrences, 44.1% for vaginal and parametrial recurrences and 42.9% for parametrial recurrences. When the disease extent was classified in the same way as the staging system of FIGO, the 4 year survival was 80.4, 73.0, 25.0 and 0 percent for stage lla, llb and IVa, respectively.
Asunto(s)
Humanos , Supervivencia sin Enfermedad , Oncología por Radiación , Radioterapia , Recurrencia , Seúl , Tasa de Supervivencia , Neoplasias del Cuello Uterino , VaginaRESUMEN
The early carcinoma of the uterine cervix may be treated by either radical surgery or radical radiotherapy according to the patient's characteristics, and the survival is high with either treatment. But, because of the size of the lesion, metastasis to lymph nodes, and vascular space invasion by tumor have all been shown to influence recurrence and survival, postoperative radiotherapy may be considered as their histopathologic finding after radical surgery. However, there are still debates on the increasing survival rates with postoperative radiotherapy. Two hundreds and three patients with carcinoma of the uterine cervix who were treated with postoperative radiotherapy from February 1979 to September 1982 in the Department of Therapeutic Radiology, Seoul National University were analyzed and following results were obtained. 3-ear actuarial survival rate and 3-ear disease free survival rate were 83.4% and 73.4% respectively and 3-ear actuarial survival rates by stages were 90.7% for IB, 69.6% for IIA, and 85.2% for IIb. 3-ear actuarial free survival rates by stage IB, IIA, IIB were 79.8%, 67.8%, 68.3% respectively. The overall failure rate was 25.1%(51/203); local recurrence rate was 8.4%, distant metastasis rate was 14.3% and simultaneous local recurrence and distant metastasis was 2.4%. Failure rates by stages were 19.8%(18/19) for IB, 29.1%(16/55) for IIA and 29.8%(17/57) for IIB. The overall acute complication rate was 57.6%; tolerable cases was 50.2% and severe cases was 7.4%, Late complication rate was 7.9% and the major late complication were intestinal obstruction, aggravated urinary symptom, radiation cystitis in order of frequency.