Biswal B M, Mohanti B K, Rath G K, Kumar L, Kriplani A, Ganesh T, Takkar D, Kumar S
Department of Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Clin Oncol (R Coll Radiol). 1994;6(6):356-60. doi: 10.1016/s0936-6555(05)80185-2.
A retrospective analysis is described of 271 diagnosed cases of carcinoma of the uterine cervix who were treated with radical radiotherapy between January 1987 and July 1988 at the Institute Rotary Cancer Hospital. The mean age at presentation was 49 years and 89% of the tumours were FIGO Stage II and III. The median duration of follow-up was 60 months. The early cases were treated with two intracavitary insertions of 34 Gy each to point A with a Selectron LDR intracavitary system, followed by 36 Gy external radiotherapy to the parametrium. Late stage disease was treated with 50 Gy of external radiotherapy, followed by a single intracavitary insertion of 30 Gy to point A. To compensate for the higher dose rate of the Selectron (180 cGy/h) a dose reduction factor of 15% was applied over the intracavitary dose. There were 2.5% and 4.7% of late Grade III bladder and bowel complications, respectively, requiring surgical intervention. There was no relationship between haemoglobin level at diagnosis and the development of late complications. The actuarial 5-year survivals were 65%, 63% and 35% for Stages I, II and III disease, respectively. This study from the Indian subcontinent shows the effectiveness of radiotherapy in Stages I, II and III carcinoma of the uterine cervix, with acceptable morbidity rates.
对1987年1月至1988年7月期间在印度扶轮癌症医院接受根治性放疗的271例确诊子宫颈癌病例进行了回顾性分析。就诊时的平均年龄为49岁,89%的肿瘤为国际妇产科联盟(FIGO)II期和III期。中位随访时间为60个月。早期病例采用Selectron低剂量率腔内照射系统,分两次腔内插入,每次向A点给予34 Gy,随后对宫旁组织进行36 Gy的外照射。晚期疾病采用50 Gy的外照射,随后单次腔内插入向A点给予30 Gy。为补偿Selectron较高的剂量率(180 cGy/h),腔内剂量应用15%的剂量降低系数。分别有2.5%和4.7%的患者发生III级晚期膀胱和肠道并发症,需要手术干预。诊断时的血红蛋白水平与晚期并发症的发生无关。I期、II期和III期疾病的精算5年生存率分别为65%、63%和35%。这项来自印度次大陆的研究表明,放疗对I期、II期和III期子宫颈癌有效,且发病率可接受。