병기 Ⅲ 자궁경부암의 방사선치료 결과

• 영문명: Results of Radiation Therapy in Stage Ⅲ Uterine Cervical Cancer
• 발행기관: 대한방사선종양학회
• 저자명: 문창우(Chang Woo Moon) 신병철(Byung Chul Shin) 염하용(Ha Yong Yum) 정태식(Tae Sig Jeung) 유명진(Myung Jin Yoo)
• 간행물 정보: 『대한방사선종양학회지』제13권 제3호, 259~266쪽, 전체 8쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1995.09.30

영문 초록

Purpose : The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage Ⅲ uterine cervical cancer. Materials and Methods : From January 1980 through December 1985. 227 patients with stage Ⅲ uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients(31.7%) were stage Ⅲa, and 155 patients(68.3%) were stage Ⅲb according to FIGO classification. Age distribution was 32-71 years (median: 62 years). Sixty nine patients(95.8%) in stage Ⅲa and 150 patient (96.8%) in stage Ⅲb were squamous cell carcinoma. Pelvic lymph node metastasis at initial diagnosis was 8 patients (11.1%) in stage Ⅲa and, 36 patinets (50%) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr.) and 36 patients (50%) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with Cs sources, and among 155 patients with stage Ⅲb, 80 patients (51.6%) were treated with external radiation therapy alone and 75 patients (48.4%) were treated with external radiation therapy with ICR. Total radiation doses of stage Ⅲa and Ⅲb were 65-105 Gy(median: 78.5 Gy) and 65-125.5 Gy(median: 83.5 Gy). Survival rate was calculated by life-table method. Results : Complete response rates were 58.3%(42 patients) in stage Ⅲa and 56.1%(87 patients) in stage Ⅲb. Overall 5 year survival rates were 57% in stage Ⅲa and 40% in stage Ⅲb. Five year survival rates by radiation technique in stage Ⅲa and Ⅲb were 64%. 40% in the group treated in combination of external radiation and ICR, and 50%, 40% in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage Ⅲa and Ⅲb were 90%, 66% in responder group, and 10%, 7% in non-responder group (P<0.001). There were statistically no significant differences of 5 year survival rate by total radiation doses and external radiation doses(40 Gy vs 50 Gy) of whole or true pelvis in stage Ⅲa and Ⅲb(P=NS). Treatment failures rates were 40.3%(29 patients)in stage Ⅲa and 57.4%(89 patinets) in stage Ⅲb. 17 patients (23.6%) in stage Ⅲa and 46 patients (29.7%) in stage Ⅲb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage Ⅲa(50%) and Ⅲb(50%). Serious complication rates were higher in group received external radiation doses of 50Gy than 40Gy whole or true pelvis in stage Ⅲa and Ⅲb. Serious rectal complication developed in rectal doses mor than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of death was cachexia due to locoregional failure in both stage Ⅲa(34.7%) and Ⅲb(43.9%). Conclusion : From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50Gy than 40Gy to whole or true pelvis produced serious rectal and bladder complications in stage Ⅲ uterine cervical cancer.

키워드

Uterine cervical cancer Radiation therapy