TY - JOUR
T1 - Specimen findings and survival after preoperative 252Cf neutron brachytherapy for Stage II cervical carcinoma
AU - Maruyama, Yosh
AU - Donaldson, Elvis
AU - van Nagell, John R.
AU - Yoneda, Justine
AU - Gallion, Holly H.
AU - Powell, D.
AU - Kryscio, Richard J.
PY - 1991/12
Y1 - 1991/12
N2 - Twenty-seven patients with operable Stage II cervical cancer with a mean diameter tumor of 8.0 cm were studied in a feasibility study using preoperative 252Cf implants plus whole-pelvis radiation to 45 Gy followed by extrafascial total abdominal hysterectomy and bilateral salpingo-oophorectomy 4 to 6 weeks later. Hysterectomy specimens were studied by a set protocol. With the protocol used, 13 27 (51%) specimens and abdominal stagings were negative for residual tumor. The survival rate for the patients with negative findings was 93% at 5 years. In 14 27 (49%) patients the specimens were positive for residual tumor. In contrast, the 5-year survival rate for this group was 46% (P < 0.001). In these patients several interrelated factors were determined to be of importance, i.e., (1) tumor size>8 cm in maximum diameter, (2) positive or negative residual tumor status, and (3) total dose of radiation given. Survival was lower for larger tumors and specimens were more likely to show residual tumor. A lower treatment dose led to more positive specimens, as well as to poorer survival. While the patients with Stage II disease fared very well when negative specimens were found, further prospective studies of the appropriate treatment for those with positive tumor specimens are needed.
AB - Twenty-seven patients with operable Stage II cervical cancer with a mean diameter tumor of 8.0 cm were studied in a feasibility study using preoperative 252Cf implants plus whole-pelvis radiation to 45 Gy followed by extrafascial total abdominal hysterectomy and bilateral salpingo-oophorectomy 4 to 6 weeks later. Hysterectomy specimens were studied by a set protocol. With the protocol used, 13 27 (51%) specimens and abdominal stagings were negative for residual tumor. The survival rate for the patients with negative findings was 93% at 5 years. In 14 27 (49%) patients the specimens were positive for residual tumor. In contrast, the 5-year survival rate for this group was 46% (P < 0.001). In these patients several interrelated factors were determined to be of importance, i.e., (1) tumor size>8 cm in maximum diameter, (2) positive or negative residual tumor status, and (3) total dose of radiation given. Survival was lower for larger tumors and specimens were more likely to show residual tumor. A lower treatment dose led to more positive specimens, as well as to poorer survival. While the patients with Stage II disease fared very well when negative specimens were found, further prospective studies of the appropriate treatment for those with positive tumor specimens are needed.
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U2 - 10.1016/0090-8258(91)90030-9
DO - 10.1016/0090-8258(91)90030-9
M3 - Article
C2 - 1752495
AN - SCOPUS:0026329254
SN - 0090-8258
VL - 43
SP - 252
EP - 259
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 3
ER -