Postoperative radiotherapy of cervival carcinoma: treatment results and analysis of prognostic factors

The purpose of the study was to evaluate the efficacy of postoperative radiotherapy (RT) and to investigate prognostic factors for early-stage cervical cancer patients. We reviewed the medical records of 162 cervical cancer patients treated by RT during 2003 year. RT included 30-45 Gy of external photons to pelvis in 12-25 fractions. Brachytherapy with 192Ir was delivered in 3-5 fractions to a dose of 27-32 Gy. The mean age was 49 years (range 27-71). Majority of patients 130 had Stage Ib. Radical hysterectomy with lymphadenectomy was performed in 122 pts. and simple hysterectomy in 40 pts. The 5-year actuarial overall survival (OS) for all patients was 92.6% and disease-free survival (DFS) was 90.9%.There was statistically significant differences in OS and DFS in pat. with positive vs. negative pelvic lymph nodes; tumor 4 cm vs. tumor < or = 4 cm; positive vs. negative surgical margin/residual tumor (p < 0.05). Late GIT complications were determined in 35.8% and UT in 12.3%. In conclusion, postoperative radiotherapy has achieved high-satisfactory survival with acceptable complications. The survival benefit was less evident among patients with positive lymph nodes, tumor > 4 cm and positive surgical margin/residual tumor.