Background: The most important factors for prognosis of cervical cancers are age and histological criteria such as the tumor size, the involvement of Lymph nodes, Lympho-vascular space involvement as well as microvessel involvement and poor tumor differentiation (grading 3). Here we present the results of concomitant chemo-radiation at high-risk situation of patients with cervical cancer after surgery. Patients and Methods: The study comprised 34 patients with median age of 40 years (26-63 years) after Wertheim surgical technique for cervical cancer at the FIGO Stages IB (n = 19) and IIB (n = 15). All patients were treated between November 1995 and June 1999 by a schedule of concomitant chemoradiation. The indication for this treatment was given by the positive histological proof of Lymph node metastasis, microvessel or Lympho-vascular space involvement as well as a G3 grading. The chemo-therapy was given in week 1 and 5 (day 1-5 and day 29-33). The dosage of cisplatin was 20 mg/m2/d on every day and 5-FU was given as a 120-h infusion with 600 mg/m2/d. The external beam radiotherapy was applied to the pelvis with 1.8 Gy per fraction up to 50.4-54 Gy. In two patients the paraaortal region was irradiated too because of the involvement of these Lymph nodes. Results: The median observation time was 48 months (3-68 months). 30 patients are alive (88%) in complete response. Four patients died. The mean survival was 61 ± 3 months. We have seen only slight acute toxicities of grade 1 and 2. Three patients suffered from a grade 3 diarrhea and three patients developed a grade 3 Leukopenia. In seven patients we found a secondary Lymphedema as a late toxicity. Conclusion: The concomitant chemoradiation containing cisplatin in high-fisk situation for cervical cancer after surgery improves the outcome and survival in these patients.
|Translated title of the contribution
|Adjuvant simultaneous radiochemotherapy following radical hysterectomy for patients with cervical cancers in high-risk situation - Results of a pilot study
|Strahlentherapie und Onkologie
|Number of pages
|Published - 2002