Investigating the Indication of Post Operation Radiotherapy in Cervical Cancer Patients

Document Type : Original Article

Authors

1 Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor of Radiotherapy, Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Cervical cancer is preventable but still its mortality is 50% in our country. Primary treatment (surgery or radiotherapy) should be carefully planned to avoid radiotherapy after surgery which has high morbidity. In this study, the indications of post operation radiotherapy and errors of treatment that impose combined modality to patients were determined and some suggestions were given to surgeons, radiotherapists and pathologists.
 
Methods: This descriptive and analytical research was held on patients with cervical cancer who referred to Qaem and Omid tumor clinics from 1988 to 2008 and had been treated with radiotherapy after hysterectomy. Patients’ statuses in first refer (clinical-pathological), follow up after radiotherapy in term of recurrence or death were studied in 93 records. Survival rate was evaluated with kaplan-meier method. General linear model and chi-square test were used to compare of variables. P less than 0.05 was considered statistically significant.
 
Results: 28 patients had radical hysterectomy, 55 patients had simple and 10 patients had supracervical hysterectomy. 3and 5-year disease-free survival were respectively 57.1% and 52.8% and 3 and 5-year overall survival were respectively 76.2% and 67%. Error rate during treatment and doing radiotherapy after hysterectomy were 64 surgeon errors , 23 pathologist errors, 6 radiotherapist errors and 8 patients’ referring error.
 
Conclusion: Appropriate follow-up before doing hysterectomy in cervical cancer and being careful for postoperative treatment improve the treatment of patients with cervical cancer. Most of radiotherapy after hysterectomy cases was the result of inoperative surgery. Therefore, if hysterectomy is needed for any reason, we must be sure of health of patient's cervix by patient’s examination and answer of cytology.

Keywords

References

1. Robat M, Holtz D, Dunton CJ. A review of topotecan in combination chemotherapy for advanced cervical
cancer. Ther Clin Risk Manag 2005 Feb;4[3]:213-8.
2. International agency for research on cancer. Cancer Incidence, Mortality and Prevalence Worldwide in 2008.
Available at: http://globocan.iarc.fr
3. Bidus MA, Elkas JC. Cervical and vaginal cancer. In: Berek JS. Berek & Novak’s gynecology. 14th ed.
Philadelphia:Lippincott Williams & Wilkins;2007:1403-56.
4. Halperin EC, Perez CA, Brady LW. Perez and Brady’s principles and practice of radiation oncology. 5th ed.
Philadelphia:Lippincott Williams & Wilkins;2008:1532-609.
5. Hacker JS, Friedlander ML. Cervical cancer in gynecologic oncology. In: Berek JS, Hacker NF. Berek &
Hacker’s gynecologic oncology. 5th ed. Philadelphia:Lippincott Williams & Wilkins;2010:341-96.
6. Liu MT, Hsu JC, Liu WS, Wang AY, Huang WT, Chang TH, et al. Prognostic factors affecting the outcome of
early cervical treated with radical hysterectomy and post-operative adjuvant therapy. Eur J Cancer Care (Engl)
2008 Mar; 17(2):174-81.
7. Shibata K, Kajiyama H, Terauchi M, Yamamoto E, lno K, Nawa A, et al. Feasibility and effectiveness of
postoperative adjuvant concurrent chemoradiation theropy in Japanease patients with high-risk early-stage
cancer of uterine cervix. lnt J Clin Oncol 2008 Jun;13(3):233-8.
8. Yessaian A, Magistris A, Burger RA, Monk BJ. Radical hysterectomy followed by tailored postoperative
therapy in the treatment of stage IB2 cervical cancer: feasibility and indications for adjuvant theraphy. Gynecol
Oncol 2004 Jul;94(1):61-6.
9. Rogers L, Siu SS, Luesley D, Bryant A, Dickinson HO. Radiotherapy and chemoradiation after surgery for
cervical cancer. Cochrane Database Syst Rev 2010 May 16; 5:CD007583.
10. Greimel ER, Winter R, Kapp KS, Haas J. Quality of life and sexual functioning after cervical cancer treatment: a
long-term follow-up study. Psychooncology 2008 May; 18(5):478-82.
 
11. Pieterse QD, Trimbos JB, Dijkman A,Creutzberg Cl, Gaarenstroom KN, Peters AA , et al. Potoperative radiation
therapy improves prognosis in patients with adverse risk factors in localized, early–stage cervical cancer: a
retrospective comparative study. Int J Gynecol cancer 2006 May–Jun; 16(3):1112-8.
12. Lasry S, Cohen-Solal C, Hacene K, Delouche G, Brunet M, Quatramiz A, et al. [Long-term results of radiosurgical
treatment of operable carcinoma of the cervix uteri] [Article in French]. Bull Cancer 1990;77(4):355-62.
13. Kasamatsu T, Onda T, Sawada M, Kato T, Ikeda S, Sasajima Y, et al. Radical hysterectomy for FIGO stage I–
IIB adenocarcinoma of the uterine cervix. Br J Cancer 2009 May 5; 100(9):1400–5.

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