초기 자궁경부암의 수술 후 방사선치료 결과

• 영문명: Therapeutic Results Postoperative Radiation Therapy for Early Stage Uterine Cervical Cancer
• 발행기관: 대한방사선종양학회
• 저자명: 강승희(Seung Hee Kang) 서현숙(Hyun Suk Suh)
• 간행물 정보: 『대한방사선종양학회지』제11권 제2호, 347~354쪽, 전체 8쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1993.12.29

영문 초록

This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991. Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 (3%), 39 (58.2%), and 26 (38.8%), respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were 88.0%;and;82.1%, respectively. The survival rates by stage were 87.1% in IB and 88.4% in IIA. Local control rate was 80.6%(58 pts). The treatment failure was noted in 12 of 67 patients (17.9%): locoregional failure in 7(10.4%), distant metastasis in 3 (4.5%), and locoregional and distant metastasis in 2(3%), The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence (70.0% vs 91.1% P<0.05 & 30.0% vs 15.8%, respectively). The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size (≥3 cm), parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.

키워드

Early stage cervical cancer Postoperative radiation therapy