[High-dose intracavitary brachytherapy of a recurrent cervical cancer following surgery]

Forty-nine postoperative cancer patients with a recurrent cervical cancer at the vaginal stump were treated with high-dose intracavitary brachytherapy with or without external irradiation. The intervals between their previous surgery and the vaginal recurrence ranged widely, from 4 months to 36 years. The overall 10-year survival rate after radiotherapy was 48%. The patients were classified into two groups, according to the tumor size that was evaluated by rectovaginal examination at time of recurrence, that is, one group without a palpable mass at the vaginal stump and one with a palpable mass. The 10 year-survival rate with or without the palpable mass was 8% and 80%, respectively. External irradiation combined with brachytherapy could not modify the survival rate of those that had been treated by brachytherapy alone in the group without the palpable mass. On the other hand, the incidence of late intestinal complications was increased by the combination of external irradiation. This result suggests that the most important prognostic factor in cases of a recurrent cervical cancer at the stump is the tumor size.