Results of radiation therapy on cervical cancer

Between 1969 and 1985, a total of 298 patients with cervical cancer were treated by radiation therapy at the Department of Radiology, Gunma University Hospital. Another 111 patients were treated with irradiation as a follow up to surgery; 69 for prophylactic reasons and 42 to treat residual tumors. Patients treated with irradiation alone were given a combination of external irradiation to the pelvis and low dose rate intracavitary irradiation. Patients treated post-operatively were given intracavitary electron beam irradiation of the resected end of the vagina, and external irradiation of the entire pelvis. The following results were obtained: In patients treated by radiation therapy alone, the relative 5-year survival rates according to clinical stage were: 108% for patients with stage I cancer, 90% for stage II, 62% for stage III, and 31% for stage IV. Stage IV patients with no evidence of hematogenous metastasis could be candidates for radical therapy. Local recurrence was observed in 13% of stage II and III patients, attributed to inadequate intracavitary treatment and the histological diagnosis of adenocarcinoma. Severe complications occurred in only 12 (4%) of the 298 patients treated with irradiation alone. The relative 5-year survival rates for patients treated with post-operative irradiation were 91% for patients treated prophylactically and 49% for patients treated for residual tumor. Patients treated with post-operative irradiation for residual tumor at the resected end of the vagina showed a high cumulative survival rate of 77%. Since urinary sequelae developed in only 4 patients, it would seem that electron beam irradiation of the resected end of the vagina is a safe and effective method of therapy. (author)