10-Gy single-fraction pelvic irradiation for palliation and life prolongation in patients with cancer of the cervix and corpus uteri

Objective. The goal of this study was to evaluate the effects of single fra ctions of 10 Gy pelvic irradiation for palliation and life prolongation in patients with cancer of the uterine cervix or corpus. Methods. A retrospective analysis was performed on 37 cervical cancer and 2 7 corpus cancer patients treated in the period 1988-1998. All patients had a life expectancy of less than 1 year. Due to stage of disease, age (median 82 years), or comorbidity they were considered unapt for surgery or conven tional radiotherapy. Eleven patients with recurrence within irradiated held or early progression received one, 51 patients received two, and 2 patient s received three fractions with a 4-week interval. Results. Vaginal bleeding stopped in 90% and malodorous discharge in 39% of the patients. Among 46 patients with advanced disease treated for palliati on, 10 (22%) showed complete tumor responses. Median time to progression wa s 6 months, and median survival, 9 months. Eighteen patients with early-sta ge disease and serious comorbidity were treated with life prolongation and symptom prevention as intention, and showed seven complete responses. Media n survival was 13 months, and half the deaths were caused by intercurrent d isease. Median hospital stay was 5 days and rehabilitation was easy. Fifty- six percent of the patients experienced no acute side effects and 33% had m inor gastrointestinal problems. Three patients (6%) had serious late bowel complications, one with a fatal outcome, the symptoms appearing 9-10 months posttreatment. Conclusion. The 10-Gy single-fraction pelvic radiation regimen is an effect ive means of symptom palliation and is well tolerated. Tumor responses are obtained. The risk of late bowel complications is a concern for patients wi th a life expectancy greater than 9-months. (C) 2001 Academic Press.