Kumagaya H, Ito H, Hashimoto S
Dept. of Radiology, Keio Univ., School of Med.
Gan No Rinsho. 1990 Jan;36(1):51-6.
Forty-nine postoperative cancer patients with a recurrent cervical cancer at the vaginal stump were treated with high-dose intracavitary brachytherapy with or without external irradiation. The intervals between their previous surgery and the vaginal recurrence ranged widely, from 4 months to 36 years. The overall 10-year survival rate after radiotherapy was 48%. The patients were classified into two groups, according to the tumor size that was evaluated by rectovaginal examination at time of recurrence, that is, one group without a palpable mass at the vaginal stump and one with a palpable mass. The 10 year-survival rate with or without the palpable mass was 8% and 80%, respectively. External irradiation combined with brachytherapy could not modify the survival rate of those that had been treated by brachytherapy alone in the group without the palpable mass. On the other hand, the incidence of late intestinal complications was increased by the combination of external irradiation. This result suggests that the most important prognostic factor in cases of a recurrent cervical cancer at the stump is the tumor size.
49例阴道残端复发性宫颈癌的术后癌症患者接受了高剂量腔内近距离放射治疗，部分患者联合外照射。她们上次手术至阴道复发的间隔时间差异很大，从4个月到36年不等。放疗后的总体10年生存率为48%。根据复发时经直肠阴道检查评估的肿瘤大小，将患者分为两组，即阴道残端无可触及肿块的一组和有可触及肿块的一组。有或无可触及肿块患者的10年生存率分别为8%和80%。对于阴道残端无可触及肿块的组，外照射联合近距离放射治疗并不能改变单纯接受近距离放射治疗患者的生存率。另一方面，外照射联合治疗会增加晚期肠道并发症的发生率。这一结果表明，残端复发性宫颈癌病例中最重要的预后因素是肿瘤大小。
