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Cancinoma of Uterine Cervix Treated with High Dose Rate Intracavitary Irradiation: 1. Pastterns of Failure

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Author(s)
Ok Bae KimTae Jin ChoiJin Hee KimHo Jun LeeYung Ae KimYoung Wook SuhTae Sung LeeSoon Do Cha
Publication Year
1993
Keyword
CervixHigh dose rateBrachytherapyPatterns of faiure
Abstract
226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July, 1988 to May, 1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses(for a total of 4500~6300 cGy) with midline shill(4x10 cm), and combined with intracavitary irradiation irradiation(5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37(16.4%), stage IIA 91 (40.3%), Stage IIB 58(25.7%), stage III 32(13.8%), stage IV 8 (3.5%). The overall failure rate was 23.9%(54 patients). The failure rate increased as a function of stage from 13.5% in stage 1B to 15.4% in stage IIA, 25.9% in stage IIB, 46.9% in stage III, and 62.5% in stage IV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure, 28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical(point A) doses were 6700 cGy in stage IIB, 7200 cGy in stage IIA, 7450 cGy in stage IIB, 7600 cGy in stage III and 8100 cGy in stage IV. The medial paracevical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple Increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.
Alternative Title
자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰
Department
Dept. of Radiation Oncology (방사선종양학)
Dept. of Medical Biophysics Engineering (의공학과)
Dept. of Obstetrics & Gynecology (산부인과학)
Publisher
School of Medicine
Citation
대한치료방사선과학회지, Vol.11(2) : 369-376, 1993
Type
Article
ISSN
1225-6765
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/39721
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