Primary radiotherapy for stage IB or IIA cervical cancer

Patients with carcinoma of the cervix (stages IB-IIA) have a tumor that is confined to the cervix and upper vagina. These patients, however, may have a tumor that ranges in diameter from less than 1 cm to as large as 10 cm. The survival for all patients with stage IB disease is 86%; for those with stage IIA disease, it is 72%. Reports of radiotherapy alone for small stage IB or IIA cervical cancer indicate a cure rate of greater than 90% and a severe complication rate of less than 5%. Bulky cervical cancers of stages IB-IIA treated with high doses of radiation have survival and complication rates that are dependent on tumor size, and no survival benefit has been demonstrated with the addition of a hysterectomy. Elective para-aortic irradiation has been demonstrated to be of benefit in this patient population. The quality of life for patients treated with radiotherapy alone depends on many factors.