• Radiation Oncology Journal
• /
• v.5 no.2
• /
• pp.131-136
• /
• 1987

Forty seven patients with locally recurrent uterine cerival cancer after surgery were treated with radiation during the 6 year period from 1979 through 1984 at the Department of Therapeutic Radiology of Seoul National University Hospital. In 30 out of the 47 patients, recurrence was diagnosed within 2 years after surgery. Site of recurrence was vagina in 19 patients, vagina and parametrium in 21 patients and parametrium only in 7 patients. Complete tumor control was achieved in 35 patients $(74.5\%)$; the complete response rates were $94.7\%(18/19)$ in vaginal recurrences, $57.1\%(12/21)$ in combined vaginal and parametrial recurrences and $71.4\%(5/7)$ in parametrial recurrences. Overall and disease free survival rates at 4 years were 55.2 and 50.1 percent, respectively, for entire group. Overall 4 year survival rates were $77.0\%$ for vaginal recurrences, $44.1\%$ for vaginal and parametrial recurrences and $42.9\%$ for parametrial recrrences. When the disease extent was classified in the same way as the staging system of FIGO, the 4 year survival was 80.4, 73.0, 25.0 and 0 percent for stage IIa, IIb, IIIb and IVa, respectively.

• Radiation Oncology Journal
• /
• v.17 no.3
• /
• pp.217-222
• /
• 1999

Purpose : To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. Materials and Methods : Between October 1983 and July 1990, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five ($84.9\%$) patients had squamous cell carcinoma, seven ($13.2\%$) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients ($77.4\%$) and pelvic side wall in 12 patients ($22.6\%$). Recurrent tumor size was devided into two groups : less than 3 cm in 43 patients ($81.1\%$) and more than 3 cm in 10 patients ($18.9\%$). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients ($34\%$) or intracavitary irradiation in 24 patients ($45.3\%$). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. Results : Overall response rate was $66\%$ (35/53). Among them, six patients ($17.1\%$) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months), Therefore overall recurrence rate was $45.3\%$. Overall five-year actuarial survival rate was $78.9\%$ and distant failure rate was $10\%$ (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 ($20/%$) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. Conclustion : Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer.