STATISTICAL STUDY OF A SERIES OF 672 CARC INOMAS OF THE CERVIX - RESULTS AND COMPLICATIONS ACCORDING TO AGE AND MODALITIES OF TREATMENT

The study bears on 672 infiltrating carcinomas of the cervix treated f rom 1977 until the end of 1991, by a radiosurgical combination (311 pa tients) or by exclusive irradiation (361 patients). The radiosurgical series includes mostly stages IB and II and patients under 50 years be cause of the therapeutic protocol. Most of the patients aged over 50 y ears and all stages III were treated by exclusive irradiation. Externa l beam irradiation was most often performed in 4 fields by linear acce lerator of 12 and 25 MeV. Uterovaginal brachytherapy used the techniqu e of molds. In 55 cases, a complementary interstitial brachytherapy wa s applied on residual node. A computer dosimetry was made for each pat ient,with calculation of the doses delivered to organs at risk and to node areas (points of calculation ICRU n degrees 38). The results at 5 years are as follows for the total series: locoregional control (LRC) 79%, specific survival (SS) 73%, overall survival 70%. For stage 1, t he LRC of the radiosurgical series is 92%, that of the series of exclu sive irradiation 87% (no significant difference, neither for SS if we consider the tumoral size); For stage II, the LRC is 70% in the radios urgical series and 79% in the series of exclusive irradiation. There i s no difference if proximal stage II is compared. Conversely, for dist al stage II, the difference is very significant in favour of exclusive irradiation (LRC 31 %/77%, SS 26%.70%, p < 0.006). If we consider the results according to age, the difference for distal stage II comes mo stly from patients under 50 years and especially those aged 40 years o r under. For stage III, the LRC is 61% for patients over 50 years and 34% for those aged 50 years or under (p = 0.006). As the nodes, the re sults of surgical pieces and lymphadenectomy are studied. The patients under 40 years in stages II and III present more metastases than othe rs (p = 0.003). Among the therapeutic factors, the dose rate and the t reatment duration were particularly studied. A detailed study of the c omplications is made for the radiosurgical series as for the series of exclusive irradiation according to the French Italian glossary of com plications as well as a study of the factors inducing them.