Clinical efficacy of radiotherapy in treatment of recurrent lesions at vaginal cuff after hysterectomy for cervical cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To analyze the long-term efficacy and adverse effects of radiotherapy in the treatment of recurrent lesions at the vaginal cuff after hysterectomy for cervical cancer, and to investigate prognostic factors.Methods A total of 105 patients who were admitted to our hospital due to recurrent lesions at the vaginal cuff after hysterectomy for cervical cancer from January 2005 to July 2011 were enrolled in this study and divided into group A (6-12 months), group B (12-24 months), and group C (≥24 months) according to the time to recurrence.All patients received radiotherapy and only 96 patients also received concurrent chemotherapy.The long-term outcomes and adverse events were compared between the three groups, and the prognostic factors were analyzed.Survival curves were analyzed by the Kaplan-Meier method.Results The follow-up rate was 98.1%.The response rates of group A, B, and C were 60%, 82%, and 86%, respectively.The 3-and 5-year survival rates for all patients were 58.1% and 31.4%, respectively.The median survival time for all patients was 42 months.Group C had a significantly longer median survival time than group A (P=0.010).The patients with a maximum tumor diameter of<4 cm had a significantly better treatment outcome than those with a maximum tumor diameter of ≥4 cm (P=0.000).There was a significant difference in median survival time between the patients with recurrent lesions limited to the vaginal cuff and those with recurrent lesions beyond the vaginal cuff (47 months vs.32 months, P=0.005).Conclusions For patients with recurrent lesions at the vaginal cuff after hysterectomy for cervical cancer, radiotherapy is a salvage treatment and has significant clinical efficacy.The treatment outcome and prognosis are related to time to recurrence, tumor size, and the extent of recurrent lesions.