Long-term survival of hypoxia radiotherapy for carcinoma of uterine cervix

Objective: To evaluate the relationship between long-term survival rate and protection to marrow and lymphoid tissues in the pelvis with hypoxia radiotherapy for uterine cervical carcinoma. Methods: 113 patients, confirmed as having carcinoma of uterine cervix by pathology, were randomly divided by the envelope method into two groups: hypoxia radiotherapy group (HRG, 57 patients) and conventional radiotherapy group (CRG, 56 patients). HRG was given by sustained inhaling hypoxia gas (oxygen physical volume = 0.105) for two minutes before the start of radiotherapy till the end of radiotherapy of each field and then repeated for the other field in the same way. The duration of irradiation to each field was less than five minutes. CRG was given with conventional radiotherapy. The irradiation dose in the midpelvical plane was 20-50 Gy depending on the different stages of cervical carcinomatous lesion. The dose of four-divided-field in the parametria was 15-34 Gy. The dose at point A of intracavitary therapy was 15-35 Gy. Results: The decreased value of peripheral blood white cells after treatment was (1.36 ± 1.27) x 109/L in HRG and (2.97±1.19) x 109/L in CRG(P<0.05). E flower ring test (EFRT) increased by (6.00 ± 2.39)% and lymphocyte transformation rate(LTR) increased by (3.78±1.83)% in HRG, but decreased by (3.97±1.88)% and (4.47±1.73)% in CGR(P<0.01). The 5-year survival rate was 65% in HRG and 57% in CRG(P<0.05). The incidence of complications such as radiation proctitis and radiocystitis was also of statistically significant (P< 0.01, 0.05). Conclusions: Hematopoisis and columnar immunity can be protected by hypoxia radiotherapy for uterine cervical cancer. As a result, both long-term survival rate and life quality of patients are expected to be improved. (authors)