Gm. Thomas et al., LONG-TERM RESULTS OF CONCURRENT RADIATION AND CHEMOTHERAPY FOR CARCINOMA OF THE CERVIX RECURRENT AFTER SURGERY, International journal of gynecological cancer, 3(4), 1993, pp. 193-198
Between 1981 and 1991, 41 patients with carcinoma of the cervix recurr
ent only in the pelvis, or pelvis and para-aortic nodes after initial
surgery, were treated with concurrent chemo-radiation (CT-RT). The tot
al dose of radiation was tailored to the disease extent. Radiation was
delivered to the pelvis and/or pelvis plus para-aortic nodes. Concurr
ent infusional 5-fluorouracil 1.5 g m-2 day-1 was delivered with bid r
adiation for one to three courses of 3 or 4 days. In addition, 10 pati
ents received one or two courses of intravenous mitomycin C (Mit C) 6
MgM-2 . Twenty-three of 40 evaluable (58%) had a complete response to
CT-RT. Five have subsequently relapsed, two in pelvis alone, one in pe
lvis and distant sites and two with distant metastases only. Eighteen
of 40 (45%) remain alive without disease from 3 to 113 months (median
57 months) after CT-RT. Sustained complete remissions and apparent cur
e have occured even in poor pronosis patients with pelvic side wall or
common iliac nodal diease and those recurrent at short intervals from
surgery. Using logistic regression the following varibles were examin
ed for their prognostic significance for pelvic control and survival:
Mit C, extent of pelvic diseases number of course of 5-FU, nodal statu
s at original surgery and radiation dose. On multivariate analysis onl
y the number of courses of 5-FU used was predictive of pelvic control
and survival. Concurrent 5-FU and radiation is recommended as salvage
therapy for patients wth recurrent locoregional cervical cancer.