Radiation Oncology Journal
- Volume 17 Issue 1
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- Pages.23-29
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- 1999
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- 2234-1900(pISSN)
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- 2234-3156(eISSN)
Results of Radiation Therapy and Extrafascial Hysterectomy in Bulky Stage IB, IIA-B Carcinoma of the Uterine Cervix
종괴가 큰 병기 IB, IIA-B 자궁경부암에서 방사선치료와 Extrafascial Hysterectomy의 결과
- Kim Jin Hee (Department of Therapeutic Radiology Keimvung University, School of Medicine) ;
- Lee Ho Jun (Department of Therapeutic Radiology Keimvung University, School of Medicine) ;
- Choi Tae Jin (Department of Medical Biophysics Engineering Keimvung University, School of Medicine) ;
- Do Cha Soon (Department of Gynecology Keimvung University, School of Medicine) ;
- Lee Tae Sung (Department of Gynecology Keimvung University, School of Medicine) ;
- Kim Ok Bae (Department of Therapeutic Radiology Keimvung University, School of Medicine)
- 김진희 (계명대학교 의과대학 치료방사선과학교실) ;
- 이호준 (계명대학교 의과대학 치료방사선과학교실) ;
- 최태진 (계명대학교 의과대학 의공학교실) ;
- 차순도 (계명대학교 의과대학 산부인과학교실) ;
- 이태성 (계명대학교 의과대학 산부인과학교실) ;
- 김옥배 (계명대학교 의과대학 치료방사선과학교실)
- Published : 1999.03.01
Abstract
Purpose : To evaluate the efficacy of radiation therapy and extrafascial hysterectomy in bulky stage IB, IIA-B uterine cervix cancers. Methods and Materials : Twenty four patients with bulky stage IB and IIA-B carcinoma of the uterine cervix were treated with extrafascial hysterectomy following radiation therapy due to doubts of residual disease at Department of therapeutic radiology, Keimyung University, Dongsan Hospital, from April 1986 to December 1997 According to FIGO staging system, there were 7 patients with stage IB, 9 patients with IIA and 8 patients with IIB stage whose median age was 45. Pathologic distribution showed 16 patients with squamous cell carcinoma and 8 patients with adenocarcinoma. Seven patients had tumors that are less than 5cm in size and 17 patients had tumors with larger than 5cm. The mean interval between radiation therapy and extrafascial hysterectomy was 57 days. The radiation therapy consisted of external irradition to the whole pelvis (180 cGy/fraction, mean 4100 cGy) and parametrial boost (for a mean total dose of 5000 cGy) with midline shield (4H 10 cm), followed by intracavitary irradiation up to 7500 cGy to point A (maximum 8500 cGy). The maximum follow up duration was 107 months and mean follow up duration was 42 months. Results :Ten out of 24 patients (41.7%) had residual disease found at the time of extrafascial hysterectomies. Five year overall survival rate (5Y OSR) and five year disease free survival rate (5Y DFSR) were 63.6% and 62.5% respectively. Five year overall survival rate for stage IB and IIA was 71.4% and 50% for stage IIB. There was a significant difference in 5Y OSR and 5Y DFSR between patients with and those without residual disease (negative vs positive, 83.3% vs. 40% (P=0.01), 83.3% vs 36% (P=0.01) respectively). There was a notable tendency of better survival with adenocarcinoma than with squamous cell carcinoma (adenocarcinoma vs squamous cell carcinoma, 85.7% vs. 53.3% (P=0.1), 85.7% vs. 50.9% (P=0.1) of 5Y OSR and 5Y DFS respectivey). Total dose to A point did not make a significant difference in survival rate or the existence of residual lesion (< 7500 cGy,
목적 : 종괴가 큰 병기 IB, IIA와 IIB 자궁경부암 환자에서 방사선치료와 근막외 자궁적출술(extrafascial hysterectomy)의 효과를 알아보기 위해 본 연구를 시행하였다. 재료 및 방법 : 1986년 4월부터 1997년 12월까지 계명대학교 동산의료원 치료방사선과에서 큰 종괴로 방사선치료를 받고 잔여종양(residual lesion)이 의심되어 근막외 자궁적출술을 받은 자궁경부암환자 24명을 대상으로 하였다. 환자의 분포는 병기 IB, IIA가 각각 7명, 9명, 병기 IIB가 8명 이었고 평균연령은 42세이었다. 병리조직학적으로 편평상피암이 16명, 선암이 8명이었고 종괴의 크기는 5cm미만이 7명, 5cm이상이 17명이었다. 방사선치료후 근막외 자궁적 출술까지의 평균 기간은 57일이었다. 방사선치료는 외부 방사선치료로 전골반강에 하루에 180cGy씩 평균 5000cGy를 조사하였으며 평균 4100cGy후 4
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