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초기자궁경부암 환자에서 수술후 방사선 치료 성적

Result ofpostoperative irradiation for early uterine cervical cancer(Stage I and IIa)

고신대학교의학부논문집 1992년 8권 2호 p.157 ~ 170
정태식, 문창우, 염하용,
소속 상세정보
정태식 (  ) - 고신대학교
문창우 (  ) - 고신대학교
염하용 (  ) - 고신대학교

Abstract


170 patients who underwent radical hysterectomy and subsequent postoperative radiation for early uterine cervical cancer at Kosin medical college and Medical Center between June 1980 and dec. 1985, were studied to analysis factors affecting
survival
and late complications as well as causes of death and its results are reported.
The given irradiation dose was 5000-6000cGy with 4 6MeV X-ray and Cs-137 brachytherapy.
Overall 5 years survival rate was 81.8%(139 of 170 patients) and disease free 5 years survival rate was 78.2%(133 to 170 cases). Prognosis was significantly affected by pelvic lymph node metastasis(LN -/+; 91.9%/62.7%). The survival rate was
found not
to be affected by age, stage of disease, histologic cell types, and increasing radiation dose above 50Gy, but in 59 patients of pelvic lymph node positive, the survival was affected significantly by positive parametrial
invasion(parametrial
invasion -/+; 79.2%/51.4%).
Late complications required definitive medical or surgical treatment were found 18.2%(31/170), and most frequent one was hemorrhagic cystitis and proctitis in 18 cases.
In patients of regional nodes positive, treatment failure was noted in 28.8%(17/59 cases) most frequently ; 9 locoregional failure, 6 distant metastases, 2 locoregional failure and distant metastasis simultaneously. 31 of 170 patients
died
within 5 year ; 11 patients died of cachexia(7 of them was due to cancer) and 10 bycancer metastases(lung 8, liver 1, peritoneum 1) and 3 by intercurrent disease, and 3 by unknown cancer and one by sepsis.
Only 3 patients died by complication of fistula, intestinal obstruction and uremia.

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