Wharton J T, Jones H W, Day T G, Rutledge F N, Fletcher G H
Obstet Gynecol. 1977 Mar;49(3):333-8.
Epidermoid carcinoma of the cervix was treated in 120 patients by means of exploratory celiotomy (with semitherapeutic excision of involved lymph nodes) followed by irradiation. The size of the field used for irradiation was determined by the presence and site of lymph involvement. Of 64 patients, metastatic cancer in pelvic nodes was found in 40, and in common iliac or aortic nodes in 24. Of the 2 groups, 8 and 3 patients, respectively, survived for 2 years or more. Irradiation to extended fields (using 5500 rads at 850 rads per week) controlled the cancer satisfactorily within the treated area, but the incidence of bowel complications was high. Recurrent carcinoma usually appeared as distant metastases outside the treatment area which suggests that patients with bulky primary lesions and positive nodes actually already have systemic disease as treatment is started. A safe yet effective dosage level for radiation therapy to extended fields has not yet been established.
120例宫颈表皮样癌患者接受了剖腹探查术（同时对受累淋巴结进行半治疗性切除），随后进行放疗。放疗野的大小由淋巴结受累情况及部位决定。64例患者中，40例盆腔淋巴结有转移癌，24例髂总或主动脉旁淋巴结有转移癌。两组中分别有8例和3例患者存活2年或更长时间。扩大野放疗（每周850拉德，共5500拉德）在治疗区域内对癌症的控制效果良好，但肠道并发症的发生率较高。复发性癌通常表现为治疗区域外的远处转移，这表明在开始治疗时，原发性病变较大且淋巴结阳性的患者实际上已经存在全身性疾病。尚未确定扩大野放射治疗的安全有效剂量水平。
