High Dose Rate Cobalt-60 Afterloading Intracavitary Therapy for Cervical Carcinoma in Srinagarind Hospital - Analysis of Survival

Objective: To evaluate the actuarial survival rates in uterine cervical cancer patients treated with teletherapycombined with high dose rate (HDR) cobalt-60 brachytherapy. Materials and
Methods: A retrospective studyof uterine cervical cancer patients, stages IB-IVB (International Federation of Gynecologists and Obstetriciansrecommendations or FIGO), treated by radiotherapy alone between April 1986 and December 1988 wasconducted. The patients were treated with teletherapy 50Gy/25 fractions, five fractions per week to the wholepelvis, together with HDR cobalt-60 afterloading brachytherapy of 850 cGy/ fraction, weekly to point A for 2fractions.
Results:The study analysed the records of 141 patients with uterine cervical cancer with a mean ageof 50.0 years (range 30-78). The mean tumor size was 4.1 cm in diameter (range 1-8). Mean follow-up time was2.94 years (range 1 month - 6.92 years). The 5 year actuarial survival rates for patients with small size tumorsless than 2 cm in diameter and tumor sizes larger than 2 cm in diameter were 100% and 63.2%. The overall 5year survival rate was 63.3%. For cancer stages IB, IIB, IIIA and IIIB they were 100%, 80.3%, 100% and 54.8%and for squamous cell carcinoma and adenocarcinoma were 58.3% and 31.2%.
Conclusion: Combined HDRcobalt-60 brachytherapy and external beam radiotherapy provide a useful modality in the treatment of uterinecervical cancer, feasible for developing countries. The approach demonstrated a slightly elevated radiationmorbidity but was most effective in early stages and with small tumor sizes less than 2 cm in diameter.