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American Journal of Roentgenology, Vol 102, 152-160, Copyright © 1968 by American Roentgen Ray Society

SEQUENTIAL RADIATION THERAPY AND SURGERY FOR STAGE I AND STAGE II CANCER OF THE CERVIX

DAVID G. DECKER M.D.1 and REGINALD A. SMITH M.D.1

1 From the Mayo Clinic and Mayo Foundation: Section of Obstetrics and Gynecology

Four hundred and sixty-two patients received primary therapy for cancer of the cervix at the Mayo Clinic from 1950 through 1954. Four hundred and twelve had squamous cell epithelioma and 50 had adenocarcinoma or adenoacanthoma. One hundred and fifty patients had Stage I cancers, whereas 194 had Stage II cancers. Of these 344 patients, 114 were treated by

[See figure in the pdf file]

full irradiation with subsequent radical surgery, 173 by irradiation only, and 57 by surgery alone.

The 5 and 10 year gross survival rates for Stage I showed that survival was best for surgery alone (94.6 and 91.9 per cent, respectively), radiation therapy with surgery was next (88.6 and 85.7 per cent, respectively), and radiation therapy alone was third (67.4 and 63.7 per cent, respectively). However, further analysis showed that the survival rates for surgery alone and radiation therapy with surgery were almost identical when the patients with microinvasive lesions of the cervix were not included. Furthermore, the poor-risk patient was most frequently included in the group that received radiation therapy alone.

In patients with Stage II lesions, radiation therapy with surgery resulted in a better survival at 5 and 10 years (71.9 and 69.8 per cent, respectively), whereas the survival rates for radiation therapy alone (58.8 and 55.1 per cent) and for surgery alone (58.3 and 50.0 per cent) were nearly identical. Again the poor-risk patient was found in the group of patients who received radiation therapy alone.

The high incidence of major complications in the patients treated by radiation therapy and subsequent surgery was discouraging. Thus, in cancer of the cervix, surgery alone is somewhat preferable in Stage I and radiation therapy alone is preferable in Stage II. However, individualization of the treatment for each patient according to general health and type of malignancy still remains the most important factor in treatment.


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Copyright © 1968 by the American Roentgen Ray Society.