LONG SURVIVAL OF PATIENTS WITH UNRESECTABLE CERVICAL-CARCINOMA AFTER RADIOTHERAPY

We report our experience with radiotherapy for three patients with cer vical carcinoma in whom surgery had been downgraded to the performance of exploratory laparotomy only, because of extensive primary tumor or nodal invasion to the surrounding organs and vessels, Tumor invasion to the bladder, side wall invasion or unresectable nodal disease at th e time of exploration prevented definitive surgery in our case series, After laparotomy, we carried out radiation therapy consisting of exte rnal irradiation to the pelvis and intracavitary irradiation with high dose rate Co-60 Or low dose rate Cs-137 sources, Local and regional c ontrol was obtained in all three patients, and there was no locoregion al recurrence during >5 years of follow-up, One patient died of paraao rtic lymph node metastases, but she had no pelvic recurrence, Several authors have reported an increased risk of small bowel obstruction in patients who undergo laparotomy before radiotherapy, None of our patie nts developed small bowel obstruction, although one had anal bleeding which was cured by conservative therapy, Radiotherapy was effective fo r locoregional control in all three patients with unresectable cervica l carcinoma.