Analysis of the Survival Rate with Cervical Cancer Using ^137Cs and ^192Ir Aftedoading Brachytherapy

Analysis of the survival rate with cervical cancer using137Cs and192Ir afterloading brachytherapy

Objective To analyze and compare the survival rate for stages II and III cervical cancer treated by external irradiation plus¹³⁷Cs or¹⁹²lr. Methods The patients with cervical cancer were treated by external irradiation plus¹³⁷Cs (group A, 427 patients) or plus¹⁹²lr (group B, 156 patients). There were 170 stage II cases and 413 stage III cases. The number of cancer types were as follows: squamous cell carcinoma, 524; adenocarcinoma, 34; and adenosquamous cell carcinoma, 25. The two groups received the same external irradiation using 8 or 10 MV of X-ray. After the whole pelvis received 25–35 Gy, the focus was given a total of 45–55 Gy by four divided fields. Intracavitary irradiation was performed with one fraction of 6–7 Gy in reference dose at A point every week and a total dose of 40 -60 Gy with 6 ~8 fractions for group A; every fraction of 5 -6 Gy in reference dose of A point and total dose of 30–42 Gy with 5~7 fractions for group B. Results The 5-year survival rate of stage II and III, and total were 82.9%, 62.2%, and 67.2% for group A respectively and 85.1%, 61.5% and 69.2% for group B respectively. There were significant differences between stage II and III in each group (P< 0.05) but there were no differences in the 5-year survival rate between the two groups (P> 0.05). The late complications of the therapy were rectitis and urocystitis and with an incidence rate of 7.3% and 6.3% for group A and 9.6% and 9.0% for group B (P> 0.05). Conclusion The long-term survival rate and complications of stages II and III cervical cancer are similar when treated with external irradiation plus¹³⁷Cs or plus¹⁹²lr.