子宮頸癌之術後放射治療

Combined Postoperative Pelvic Irradiation in Carcinoma of Uterine Cervix

陳惠君(Huey-Jiun Chen) ； 林芳仁(Fang-Jen Lin) ； 陳明憲(Ming-Shen Chen) ； 王重榮(Chong-Jong Wang)

《中華放射線醫學雜誌》 17卷2期 (1992/06) Pp. 127-132

摘要

A series of 108 patients with FIGO Ia to IIb cervical carcinoma treated with radical hysterectomy following pelvic irradiation at the Department of Radiation Oncology, Chang Gung Memorial Hospital between January 1986 and December 1987 were retrospectively analyzed.
The median follow-up was 44 months. The 3-year actuarial survival rates were 71%, 80%, 88%, 59% (p＞0.05) for stage Ia, Ib, IIa and IIb, respectively. Locoregional recurrence was observed in 16 cases (15%) 5-37 months after irradiation, with unsuccessful salvage by chemotherapy and/or brachytherapy. Of these recurrent tumors, 2 were at stump and 14 in pelvic nodes. Five out of 16 local recurrences had the coexistence of distant metastasis.
Leg lymphedema of varying degree was the most common complication in this series, accounting for 41% of cases. Radiation proctitis was observed in 37% of cases, with class I through TV for 24%, 11%, 2%and 1%, respectively, according to Kottmeier criteria. It usually occurred 2-19 months (median 9 months)following irradiation.
In conclusion, combined pelvic irradiation in selective cases following hysterectomy is an effective means of local tumor control and, potentially, beneficial in term of survival. The high incidence of treatment-associated complications as well as distant metastasis suggested that a more strict preoperative selection of cases amenable for surgery and further modification of optimal radiation dose and volume are needed.

關鍵字

子宮腫瘤 ； 子宮部位放射線治療 ； 術後放射線治療 ； 併發症

並列摘要

A series of 108 patients with FIGO Ia to IIb cervical carcinoma treated with radical hysterectomy following pelvic irradiation at the Department of Radiation Oncology, Chang Gung Memorial Hospital between January 1986 and December 1987 were retrospectively analyzed.
The median follow-up was 44 months. The 3-year actuarial survival rates were 71%, 80%, 88%, 59% (p＞0.05) for stage Ia, Ib, IIa and IIb, respectively. Locoregional recurrence was observed in 16 cases (15%) 5-37 months after irradiation, with unsuccessful salvage by chemotherapy and/or brachytherapy. Of these recurrent tumors, 2 were at stump and 14 in pelvic nodes. Five out of 16 local recurrences had the coexistence of distant metastasis.
Leg lymphedema of varying degree was the most common complication in this series, accounting for 41% of cases. Radiation proctitis was observed in 37% of cases, with class I through TV for 24%, 11%, 2%and 1%, respectively, according to Kottmeier criteria. It usually occurred 2-19 months (median 9 months)following irradiation.
In conclusion, combined pelvic irradiation in selective cases following hysterectomy is an effective means of local tumor control and, potentially, beneficial in term of survival. The high incidence of treatment-associated complications as well as distant metastasis suggested that a more strict preoperative selection of cases amenable for surgery and further modification of optimal radiation dose and volume are needed.

並列關鍵字

Uterus, neoplasm ； Therapeutic radiology, uterus ； Therapeutic radiology, postoperative ； Complication