Postoperative radiotherapy of the cervical carcinoma in elderly patients: Over 60 years

Abstract

The purpose of the study was to analyze survival and late radiation effects according to performed surgery and radiation therapy in elderly patients. Between 1996-1997. year 44 patients with cervical carcinoma older then 60 years were treated with postoperative radiotherapy. Radiotherapy included external beam irradiation with TD 36-45 Gy in 18-22 fractions and endocavitar brachy-therapy with TD 28-35Gy in 4-5 fractions. We analyzed two groups of patients group I 29/44 (65,9%) had radical operation by Werthaim-Meigs vs group II 15/44 (34,1%) patients had standard operation. Median follow-up was 48 months. Survival for all patients was 70,43%. Late postirradiation effects in the gastrointestinal tract were 40,9% and in urinary tract 25% - in both groups. A larger percent of late postirradiation sequeles were on GIT in group I vs group II (44,8% vs 33,3%) and on UR tract also (31,03% vs 13,3%). The doses of external beam irradation were equalize in both groups, while brachytherapy regime 4xTD7,5Gy was more represent in group I. Late side effects and complications after postoperative radiotherapy are acceptable, but it is necessary to carry out randomized trials with different dose regime in brachytherapy.