INFLUENCE OF AGE, PRIOR ABDOMINAL-SURGERY, FRACTION SIZE, AND DOSE ONCOMPLICATIONS AFTER RADIATION-THERAPY FOR SQUAMOUS-CELL CANCER OF THEUTERINE CERVIX - A PATTERNS OF CARE STUDY

The 1973 and 1978 national surveys conducted by the Patterns of Care S tudy (PCS) for squamous cell cancer of the uterine cervix were combine d to analyze factors associated with complications after radiation the rapy (RT). Overall, 1558 patients were reviewed, with a median follow- up of 43 months. Major complications (defined as necessitating hospita lization for management) were seen in 152 of 1558 (9.8%) patients, wit h a 5-year actuarial rate of 14%. A number of pretreatment and treatme nt factors were analyzed with respect to complications. In univariate analysis, significant pretreatment and treatment factors associated wi th an increase in complications included young age, prior laparotomy f or staging, history of prior abdominal surgery, increasing stage, use of external RT, high fraction size, cesium source, and high paracentra l (PCS point A) and lateral (PCS point P) doses. Multivariate analysis showed a history of prior abdominal surgery, paracentral dose greater than 7500 cGy, use of cesium, daily fraction size greater than 200 cG y, and age younger than 40 years to be associated independently with c omplications. A detailed analysis of the type of and time to complicat ions is presented. The knowledge and skillful management of these pret reatment and treatment factors may improve the therapeutic ratio for R T, which is the most active curative modality against cervical cancer.