16 Cervix Carcinoma

352 Cervix Cancer

Table 14.3: Results of definitive radiotherapy in limited disease

Authors

N° pts

Stage

5-yr survival (%) 90-94 (DFS) 71 (OS) 52 (OS)

Local control (%)

Manchester 80-88 LDR Hunter 1993 1993 (62) Perez (87) LDR

294 45 70 384 128 353 229 315 314 169 83 130 64 173 203 95 170

I/IIA IB IIB

IB IIA IIB

85 70 72 84 70

90 81 77 93 82

Fletcher (35) LDR 494 207

IB IIA MDAH IIB MDAH

French cooperative group LDR Horiot (53) Kim (66) LDR

I MDAH IIA MDAH IIB MDAH

89 (89) 81 (85) 76 (76)

93 (95) 83 (88) 80 (78)

IB IIA IB IIA

82 78 81 74 74 80 94 62 86 65

89 91 88 84 79 90 97 74 85 80 97 82

Lowrey (74 LDR

Pernot ( 92) LDR

IIA-B prox.

Coia (18)

IB

Joslin (64, 65) HDR

I II

Petereit (93) HDR 59 64

IB II

Vienna HDR Pötter (96)

42 124

IB/IIA IIB

85 (DSS) 69 (DSS)

In conclusion, mean 5-year survival for stage IB is 85%, with a mean local control of 90%, for stage IIA 78 and 83 respectively, while for stage IIB the outcome varies considerably - probably due to patient selection – from 50% to 76% for survival and 60% to 87% for local control. 11.1.2 Locally extended disease The main treatment is definitive radiotherapy, combining external beam irradiation and brachytherapy, more recently associated with concomitant chemotherapy. Chemotherapy is also indicated in limited disease with high-risk factors (IB 2 , positive nodes). In conclusion, the mean 5-year survival for distal stage IIB varies from 65 - 70%, with local control rates of about 77%, for stage IIIB from 34 - 52%, with local control from 44 - 66%, and for stage IVA from 0 - 20%, with local control from 18 - 48%.