Long-term results of interstitial implant in locally advanced cervical cancer: A retrospective study of 50 cases

Phuc D. Nguyen, Berchmans John, Thomas J. Carmody, Kang Huang, David Scott Miller

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

A retrospective study was conducted to assess the impact of different clinical parameters on the survival (S), disease free survival (DFS), pelvic recurrence (LR), distant metastases (DM), and the development of major complications in 50 patients with locally advanced cervical cancer. The parameters were: early stage (I-II) vs. late (III-IV); tumor size, ≤6 cm vs. >6 cm; one interstitial implant (T) vs. two T vs. T + tandem-ovoid insertion (T/O); dose to point A, ≤8000 cGy vs. >8000 cGy; dose to point B, ≤6500 cGy vs. >6500 cGy; dose to point P, ≤5500 cGy vs. > 5500 cGy; bladder and rectum dose, ≤7000 cGy vs. >7000 cGy; chemotherapy vs. no chemotherapy. The median age was 48 years and the median follow-up was 23.5 months. The treatment consisted of external irradiation, low dose rate T alone (34 patients) or in combination with T/O (16 patients). Radiation and chemotherapy (CT) were given in 28 patients while 22 had no CT. At 60 months, the patients with an early and late stage had S rates of 57% and 17% respectively, P = 0.0071 and DFS rates of 57% and 22% respectively, P = 0.0031. While LR was not significantly different between patients with early and late stage, P = 0.1807, DM was, P = 0.0067. No other variable was statistically correlated with S, DFS and LR. For the whole group, LR was 42%. Twenty-two patients (44%) had DM. Six patients (12% crude incidence rate) experienced major complications: two rectovaginal fistulae, one rectal ulceration and two small bowel obstructions requiring colostomy and one hemorrhagic cystitis requiring hospitalization.

Original languageEnglish (US)
Pages (from-to)33-40
Number of pages8
JournalRadiation Oncology Investigations
Volume4
Issue number1
DOIs
StatePublished - 1996

Fingerprint

Uterine Cervical Neoplasms
interstitials
Retrospective Studies
cancer
chemotherapy
metastasis
dosage
Disease-Free Survival
Drug Therapy
Neoplasm Metastasis
insertion
Rectovaginal Fistula
rectum
Colostomy
Cystitis
bladder
Rectum
Urinary Bladder
Hospitalization
tumors

Keywords

  • distant metastases
  • locally advanced cervical cancer
  • pelvic recurrence

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Radiation

Cite this

Long-term results of interstitial implant in locally advanced cervical cancer : A retrospective study of 50 cases. / Nguyen, Phuc D.; John, Berchmans; Carmody, Thomas J.; Huang, Kang; Miller, David Scott.

In: Radiation Oncology Investigations, Vol. 4, No. 1, 1996, p. 33-40.

Research output: Contribution to journalArticle

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abstract = "A retrospective study was conducted to assess the impact of different clinical parameters on the survival (S), disease free survival (DFS), pelvic recurrence (LR), distant metastases (DM), and the development of major complications in 50 patients with locally advanced cervical cancer. The parameters were: early stage (I-II) vs. late (III-IV); tumor size, ≤6 cm vs. >6 cm; one interstitial implant (T) vs. two T vs. T + tandem-ovoid insertion (T/O); dose to point A, ≤8000 cGy vs. >8000 cGy; dose to point B, ≤6500 cGy vs. >6500 cGy; dose to point P, ≤5500 cGy vs. > 5500 cGy; bladder and rectum dose, ≤7000 cGy vs. >7000 cGy; chemotherapy vs. no chemotherapy. The median age was 48 years and the median follow-up was 23.5 months. The treatment consisted of external irradiation, low dose rate T alone (34 patients) or in combination with T/O (16 patients). Radiation and chemotherapy (CT) were given in 28 patients while 22 had no CT. At 60 months, the patients with an early and late stage had S rates of 57{\%} and 17{\%} respectively, P = 0.0071 and DFS rates of 57{\%} and 22{\%} respectively, P = 0.0031. While LR was not significantly different between patients with early and late stage, P = 0.1807, DM was, P = 0.0067. No other variable was statistically correlated with S, DFS and LR. For the whole group, LR was 42{\%}. Twenty-two patients (44{\%}) had DM. Six patients (12{\%} crude incidence rate) experienced major complications: two rectovaginal fistulae, one rectal ulceration and two small bowel obstructions requiring colostomy and one hemorrhagic cystitis requiring hospitalization.",
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