Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery

Yang,  Mi Gyoung

J Korean Soc Ther Radiol > Volume 12(3); 1994 > Article

Original Article

Journal of the Korean Society for Therapeutic Radiology 1994;12(3): 377-386.

Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery

Mi Gyoung Yang

Department of Therapeutic Radiology, Jung Ang Gil Hospital, Incheon, Korea.

ABSTRACT

PURPOSE:
The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. METHODS AND MATERIALS: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients(68%) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, 82% of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR).
RESULTS:
Complete response(CR) was achieved in 18 patients(64%). Five of eighteen patients(28%) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was 43% and the disease free survival was 31%. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation. The principal cause of death was lung metastasis(36%).
CONCLUSION:
Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well.

Key Words: Radiotherapy, Cervix cancer, Recurrent