[Estimation of treatment results and side-effects in patients with invasive uterine cervix cancer stage IIB-IVA treated with concurrent radiochemotherapy].
Mots clés
Abstrait
OBJECTIVE
The aim of the study was a comparison between two treatment methods of uterine cervix cancer--concurrent radiochemoterapy (RT + CHTH) and radiotherapy (RT). The group of 106 patients, suffering from advanced uterine cervix cancer, was analysed. 52 patients underwent treatment with concomitant radiochemioterapy, while 54 patients only radiotherapy. The factors influencing treatment results were analysed. Analysis of overall survival, time to local relapse and time to distant metastasis were analysed.
METHODS
An analysis was performed depending on deferent clinical parameters: stage, localization and diameter of the tumor, infiltration of vagina fornicis, depth and bilateral vs unilateral infiltration ofparametrials, anaemia, performance status and value of kerma. Occurence of early and late side-effects was analysed.
RESULTS
Frequency of persisting tumor after treatment depended on stage, and kerma. It did not differ between groups. Analysis of overall survival, local relapse free-time and distant metastasis free-time showed no deference between groups. Radiochemotherapy gave better results in the group of patients without anemia. In multivariate analysis only stage showed to be an independent prognostic factor for risk of death, local relapse and distant metastasis. Side-effects (nausea, vomits, leucopenia, thrombocytopenia, early side effects from intestine and bladder; and late side effects from bladder) were observed more frequently in the group treated with radiochemotherapy; the difference was statistically significant. There was no difference between both groups in the frequency of recto-vaginal and vesicovaginal fistulas.
CONCLUSIONS
1. Radiochemotherapy compared with radiotherapy shows better results in patients with advanced uterine cervix cancer, if there is no anemia. 2. Radiochemotherapy increases the frequency of early and late side-effects, it could impact negatively the quality of life during and after treatment. 3. Stage of disease was the main prognostic factor in uterine cervix carcinoma, independently of the treatment scheme that was used.
