[Preliminary results of intraoperative radiation therapy for cervical carcinoma IIb]

To assess the effects of intraoperative radiation therapy (IORT) for cervical carcinoma IIb.

One hundred and eighty-two patients with cervical carcinoma (stage IIb) underwent radiation therapy. Of them, 97 patients received IORT. They received external beam radiotherapy with 6 MV X ray 20 Gy/10 fractions to pelvic field and afterloading radiotherapy with 10-14 Gy/2 fractions on point A before operation. After having rest of 1 week, patients completed total hysterectomy and bilateral adnexectomy + intraoperative radiotherapy with 12 MeV electron beam 18-20 Gy to pelvic field (the applicator for special use in IORT of pelvic field was designed and made by us. We have the patent of China for the special applicator.) The single radiotherapy group completed external beam 30 Gy to pelvic field and 20 Gy to pelvic where shelter in the center and afterloading radiotherapy 35-40 Gy/5-6 fractions on point A.

The 5-year survival rate in the IORT group was 95%, and that in the single radiotherapy group 88%. The difference between two groups is not statistically significant (chi(2) = 1.946, P > 0.05). However, there were quite improvements of survival rate and survival quality for cervical adenocarcinoma. Their 5-year survival rates were 91% and 33% (P < 0.01), respectively in IORT group and single radiotherapy group. The incidence of the complications in the IORT group which are radioactive proctitis, bone marrow depression, and reaction of digestive system are lower than those in single radiotherapy group.

IORT provided a new therapy method for cervical carcinoma IIb especially for cervical adenocarcinoma. There are positive significance for reducing the range of the operation, decreasing complications of radiotherapy, and improving survival quality.