The effect of postoperative external radiotherapy on cervical carcinoma stage IB and IIA

Among 344 patients operated after intracavitary irradiation of cervical carcinoma stage IB and IIA, 55 had positive nodes in the operation specimen, 16 of these received no postoperative irradiation, 22 received pelvic irradiation without a boost dose to positive nodes, and 17 also received a boost. The crude 5-year survival was 52% for these 55 high-risk patients. All 3 patients with adenocarcinoma died. For squamous-cell carcinoma postoperative irradiation gave a later relapse and less distant metastases, but survival was not approved. Postoperative irradiation with a boost added, resulted in 3 recurrences among 16 patients, none in the treated volume, and only one complication. The numerically improved survival of this small group was not statistically significant, however. A randomized trial with and without postoperative irradiation with a boost dose, requiring 1100-1200 operated patients, would answer the question whether the observed improval is significant or not.