Treatment of stage I and II cervix carcinoma with radiotherapy alone or with combined radiation-surgery

From 1975 to 1982, among 138 patients affected by stage IB and IIA-B cervical carcinoma, 93 were treated with radiotherapy and surgery, while 45 were treated with radiotherapy alone. 137Cs applied with individual "moulages" was used for uterine-vaginal brachycurietherapy, while telecobalt therapy was used in external beam radiotherapy. Surgery consisted of either a classical Wertheim-Meigs procedure or a hysterosalpingo-oophorectomy with pelvic lymphadenectomy. Dosage methods for remote-loading curietherapy with 137Cs are discussed. Actuarial survival at 5 years in the 56 patients in stage IB was 90.2% +/- 3; in the 37 patients in stage IIA was 75% +/- 5; and in the 45 patients in stage IIB was 46.2% +/- 7.5. Average follow-up was 6.5 years, with a minimum of 3 years. Survival results in patients undergoing radiotherapy alone were not substantially different. Causes for therapeutic failure were pelvic relapse in 9.4% of the cases, distant metastases in 3.6% and relapse plus metastases in 8.6% of the cases. Severe complications were seen in 2.8% of the cases; mild complications in 8.6% of the cases.