721 A Review of The Outcome and Morbidity of Patients With Cervical Cancer Treated With Radical Radiotherapy

Background and Aims: High-dose-rate (HDR) brachytherapy with external beam radiotherapy has been used at our centre for several years in the treatment of cervical cancer. The study reviews the outcome and long term morbidity of the cohort of patients treated between 1998 and 2000 with radical radiotherapy alone. Methods: Case records of 88 patients with a follow-up of at least 3 months were reviewed. Results: The median age was 62 years (range = 38-89). Two were Stage 0, 21 were Stage 1, 48 were Stage 2, and 17 were Stage 3. Histology showed squamous cell carcinoma for most patients (84%). Most were moderately (66%) or poorly (22%) differentiated. Among the 85 who received external beam radiotherapy, median dose was 50Gy (range 49-66Gy) in 1.8-2Gy daily fractions in 2-4 fields, without central shielding. Six received parametrial boost (median dose = 8Gy). HDR brachytherapy was usually given in 3 fractions of 6Gy each or 4 fractions of 5Gy each, prescribed to Point A. Median duration of radiotherapy was 52 days (range = 42-80). Median follow-up was 42.7 months (range = 4.7-74.4). of the 18 failures recorded, 3 were locoregional; 15 were distant. Fourteen (15.9%) had late mild rectal morbidity (Grade 1-2). Four others had mild vaginal/bladder morbidity. Overall 5-year relapse-free survival was 70.4%; patients with Stage 1 did better (77.8%) than Stage 2 (66.7%) or Stage 3 (68.4%). Overall 5-year survival was 81.4%. Conclusions: Radical radiotherapy, incorporating HDR brachytherapy, can give effective local control, and the pattern of failure is mainly systemic. Late rectal morbidity, though mild, can be common.