Investigating the Indication of Post Operation Radiotherapy in Cervical Cancer Patients

Document Type : Original Article


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.


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.


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