Salvaging Locoregional Recurrence with Radiotherapy after Surgery in Early Cervical Cancer

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) Vol. 19; no. 10; pp. 763 - 768
• Main Authors: Jain, P, Hunter, R.D, Livsey, J.E, Coyle, C, Swindell, R, Davidson, S.E
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2007
• Subjects: Adult; Aged; Aged, 80 and over; Brachytherapy - methods; Disease-Free Survival; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Hysterectomy; Middle Aged; Morbidity; Neoplasm Recurrence, Local - radiotherapy; Radiology; radiotherapy; recurrent cervical cancer; Retrospective Studies; Salvage Therapy; survival; Treatment Outcome; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - surgery; radiotherapy; recurrent cervical cancer; Morbidity; survival
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/j.clon.2007.08.015

Abstract Aims To determine the outcome and morbidity after radiotherapy for locally recurrent cervical cancer. Materials and methods Women who presented with locally recurrent cervical cancer after surgery alone during 1985 and 1997 were identified from the hospital database. Data were collected and analysed to include the stage at first diagnosis, staging investigations before surgery, the surgical procedure, the indication for radiotherapy, the type of radiotherapy, morbidity and survival. Results In total, 130 women had radical external beam radiotherapy and/or intracavitary brachytherapy for locoregional recurrence during the defined study period. The 5-year disease-specific survival for the study population was 40.2%. Women who were treated for vault recurrence had a significantly better 5-year disease-free survival compared with women who developed nodal recurrence alone (55.4% vs 12.5%). This group of women also had a significantly slower rate of disease progression after radiotherapy than women with nodal recurrence (48.7% vs 87.5%, P = 0.0001). Conclusion Radical radiotherapy alone is able to salvage 55% of vaginal vault recurrences after surgery for cervical cancer with minimal late toxicity. Salvage rates in women with pelvic nodal recurrences are considerably lower. Chemoradiotherapy using intensity-modulated radiotherapy to deliver an escalated radiotherapy dose needs to be pursued to improve locoregional control.