[Radiotherapy of cervix cancer in an advanced stage]

Fifty nine stage II-distal (i.e. with involvement of medium third of parametrium and/or vagina), 220 stage III and 5 stage IV cervical carcinomas were treated with radiotherapy alone (combination of intracavitary radium therapy and megavoltage external irradiation on the pelvis) in the years 1971-79. The 5-year relapse free survival by actuarial method was 52.0% for stage II-distal and 40.6% for stage III, while all stage IV patients relapsed within the third year from the start of the treatment. Failures were pelvic recurrence in 98/227 patients with follow-up greater than or equal to 1 year (43.2%), distant metastases in 15 (6.7%), pelvic plus distant relapse in 10 (4.4%) and 2nd tumor in 2 (0.9%). In stage III patients the renal exclusion and positivity at lymphography were the major adverse prognostic factors and 5-year relapse free survival was respectively 28.5% and 19.6%. Improvement of the results can probably derive from a combined therapeutic approach with chemotherapy and radiotherapy in a sequential scheme.