A. Jhingran et Pj. Eifel, Perioperative and postoperative complications of intracavitary radiation for FIGO Stage I-III carcinoma of the cervix, INT J RAD O, 46(5), 2000, pp. 1177-1183
Citations number
17
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Purpose: To evaluate perioperative and postoperative complications of low-d
ose-rate (LDR) intracavitary radiation therapy in patients with FIGO Stage
I-III carcinoma of the uterine cervix,
Methods and Materials: We retrospectively reviewed the medical and radiothe
rapy records of all patients treated with radiation between 1960 and 1992 a
t The University of Texas M.D, Anderson Cancer Center for FIGO I-III carcin
omas of the cervix, Patients who had had initial hysterectomy or whose trea
tment did not include intracavitary irradiation were excluded. The final st
udy included 4043 patients who had undergone 7662 intracavitary procedures.
Results: Eleven (0.3%) patients had documented or suspected cases of thromb
oembolism resulting in 4 deaths, Of these 11 patients, 8 had clinical or ra
diographic evidence of tumor involving pelvic nodes or fixed pelvic wall. T
he risk of postoperative thromboembolism did not decrease significantly wit
h the routine use of mini-dose heparin prophylaxis (p = 0.3), Other life-th
reatening perioperative complications included myocardial infarction (1 dea
th in 5 patients), cerebrovascular accident (2 patients), congestive heart
failure or atrial fibrillation (3 patients), and halothane liver toxicity (
2 deaths in 2 patients). Intraoperative complications included uterine perf
oration (2.8%) and vaginal laceration (0.3%), which occurred more frequentl
y in patients greater than or equal to 60 years old (p < 0.01), Fourteen pe
rcent of patients had a temperature greater than or equal to 101 degrees F
during at least one hospital stay. The only correlation between minor intra
operative complications and disease-specific survival was found in patients
who had Stage III disease and uterine perforation; survival was significan
tly (p = 0.01) decreased in these patients,
Conclusions: Fatal or life-threatening complications of intracavitary treat
ment were very rare. Deep venous thrombosis (DVT) and pulmonary embolism (P
E) did not occur in otherwise healthy patients,vith early disease and were
rare even when disease was more advanced. Minor perioperative complications
were not correlated with serious late complications or with death from dis
ease. (C) 2000 Elsevier Science Inc.