Kucera H, Skodler W, Weghaupt K
Wien Klin Wochenschr. 1984 Jun 8;96(12):451-6.
In a retrospective study the incidence was determined of reversible and irreversible complications in 176 cases of cervical cancer stages I and II treated by operation and postoperative irradiation, in 329 cases of cervical cancer stages III and IV treated by irradiation alone. Severe, irreversible complications (fistulae) occurred in a significantly higher percentage of patients in the group given combined treatment (7.4%) compared with the group treated by irradiations alone (0.6%); p=0.01). The incidence of fistulae was even twice as high in the group of operated and irradiated patients with cervical cancer stages I and II than in the group of patients with cervical cancer stages III and IV treated by irradiation alone (3.2%). Hence, postoperative radiotherapy appears to be rather dangerous. Since primary irradiation achieves the same 5-year survival rate, but is connected with significantly fewer complications, it is pointed out that those cases of cervical cancer which seem to be technically operable, but will probably have to undergo postoperative irradiation, should better be treated by irradiation alone.
在一项回顾性研究中，确定了176例接受手术及术后放疗的Ⅰ期和Ⅱ期宫颈癌患者以及329例仅接受放疗的Ⅲ期和Ⅳ期宫颈癌患者中可逆性和不可逆性并发症的发生率。与仅接受放疗的组（0.6%）相比，联合治疗组中严重不可逆并发症（瘘管）的发生率显著更高（7.4%）；p = 0.01）。Ⅰ期和Ⅱ期宫颈癌手术及放疗患者组的瘘管发生率甚至比仅接受放疗的Ⅲ期和Ⅳ期宫颈癌患者组高出两倍（3.2%）。因此，术后放疗似乎相当危险。由于单纯放疗可达到相同的5年生存率，且并发症明显较少，故指出对于那些看似可进行手术但可能需要术后放疗的宫颈癌病例，最好仅接受放疗。
