Japanese Journal of Clinical Oncology 32:255-261 (2002)
© 2002 Foundation for Promotion of Cancer Research
Retrospective Analysis of Postoperative Radiotherapy for Node-negative Cervical Carcinoma with Stage IB–IIB Disease
Departments of 1 Radiation Oncology and 2 Gynecology, Aichi Cancer Center, Nagoya and 3 Department of Radiology, University of Mie School of Medicine, Tsu, Japan
Background: We performed retrospective analysis to evaluate the outcomes of postoperative radiotherapy for patients with cervical carcinoma without lymph node metastasis.
Methods: From 1981 to 1995, 68 stage I–II cervical carcinoma patients without nodal disease who received adjuvant pelvic radiotherapy were entered into the present analysis. Criteria for postoperative radiotherapy were (1) deep stromal invasion (
1/2; n = 63), (2) positive parametrial invasion (n = 38) and (3) close or positive surgical margin (n = 21). The median patient age was 54.0 years (range, 29–69 years). The median dose of 45.3 Gy (range, 43.4–56.4 Gy) was delivered over the whole pelvis median 21.0 days (range 12–68 days) after surgery.
Results: The 5/10-year overall survival, disease-free survival, pelvic control and distant metastasis-free survival rates were 89.7/85.7, 85.3/83.2, 95.5/95.5 and 90.7/90.7%, respectively. Histology of adenocarcinoma (n = 4), large tumor size and prolonged period between operation and radiotherapy were significantly adverse prognostic factors of overall and disease-free survival by univariate analysis. The risk score referred from the GOG report correlated well with disease-free survival (P = 0.018), but showed only a tendency for overall survival as a prognostic factor (P = 0.07). Overall treatment time proved to be a significant variable for overall survival (P = 0.02), but not for disease-free survival (P = 0.056). Both risk score and overall treatment time proved to be significant prognostic factors in the multivariate model. Major adverse effects occurred in three patients (4.4%) without mortality.
Conclusions: In this analysis, clinical outcome from adjuvant postoperative radiotherapy was thought to be feasible with both satisfactory pelvic control and acceptable lower toxicity.
+ For reprints and all correspondence: Takeshi Kodaira, Department of Therapeutic Radiology, Aichi Cancer Center. 1–1 Kanokoden Chikusa-ku, 464-8681 Nagoya, Aichi, Japan. E-mail: 109103@aichi-cc.jp