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[Radiotherapeutic effect and prognosis of bulky exophytic cervical cancer]
Xiao-Kang Zheng1, Long-Hua Chen, Jian Li
1Department of Radiotherapy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Objective:
To retrospectively analyze the factors affecting the radiotherapeutic effects and prognosis of patients with bulky exophytic cervical cancer.
Methods:
Sixty-four patients with bulky exophytic cervical cancer with a maximal diameter measuring 5 to 8 cm (mean 6.5 cm) were treated with a combined radiotherapy with external beam, interstitial, intracavitary irradiations. According to the FIGO staging system, 9 patients were classified as stage IIA, 19 as IIB, 5 as IIIA, and 31 as IIIB. The patients were restaged according to the same system based on the history records at the fourth week in the radiotherapy course. The cumulative survivals were analyzed with Kaplan-Meier method, and the factors influencing the prognosis including age, histology, maximal tumor diameter, stage before treatment and restage in radiotherapy were analyzed with Cox regression model.
Results:
Restaging during radiotherapy classified 9 patients as stage I, 28 as IIA, 13 as IIB, 5 as IIIA, and 9 as IIIB. The 5-year overall survival rate was 81% and the 5-year relapse-free survival rate 75.8%. Multivariate Cox regression analyses identified the restage in radiotherapy as the only significant, independent prognostic factor for overall survival (P<0.01).
Conclusions:
Radiotherapy can achieve satisfactory results for patients with bulky exophytic cervical cancer. The stage before treatment is inaccurate and not indicative of the prognosis, but the restage in radiotherapy can serve as a significant and independent prognostic factor.
