초기 자궁경부암의 수술 후 방사선 치료

• 영문명: Postoperative Radiotherapy for the Early Stage Carcinoma of the Uterine Cervix
• 발행기관: 대한방사선종양학회
• 저자명: 김진희(Jin Hee Kim) 김옥배(Ok Bae Kim) 이태성(Tae Sung Lee)
• 간행물 정보: 『대한방사선종양학회지』제11권 제2호, 337~346쪽, 전체 10쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1993.12.29

영문 초록

This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were 89.5%, and 87.8%, respectively. Their overall recurrence rate was 12.1%,(758). Distant metastasis was the most common cause of treatment failure (71.4%:5/7). The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: 95.5%, positive:69.2%, p=0.006) and hemoglobin level (≤11:75%, >11g/dl:93.3%, p=0.05) as significant factor. The age status was marginally significant (≤40:96.0%, >40:84.3% p=0.15). Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were 10.3%,(6/58). There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

키워드

Postoperative radiotherapy Early stage Carcinoma cervix