High Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual Disease

Objectives: To evaluate residual disease in uterine cervical cancer patients treated with teletherapy usingcombined high dose rate Cobalt-60 brachytherapy. Materials and
Methods: A retrospective study of uterinecervical cancer patients, FIGO stages IB-IVB (International Federation of Gynecologists and Obstetriciansrecommendations), treated by radiotherapy alone between April 1986 and December 1988 was conducted andthe outcomes analysed. The patients were treated using teletherapy 50 Gy/25 fractions, five fractions per week tothe whole pelvis together with HDR Cobalt -60 afterloading brachytherapy of 850 cGy/fraction, weekly to pointA for 2 fractions.
Results: The study covered 141 patients with uterine cervical cancer. The mean age was 50.0years with a range of 30-78 years. The mean tumor size was 4.1 cm in diameter (range 1-8 cm). Mean follow - uptime was 2.94 years (range 1 month-6.92 years). The overall incidence of residual locoregional disease was 3.5%.Residual disease, according to stage IIB, IIIB and IVA was present in 2.78%, 3.37% and 50.0%. It was notedthat there was no evidence of residual disease in stage IB and IIA cases.
Conclusion: Combined teletherapy alongwith high dose rate Cobalt -60 brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions resulted inoverall 3.5% residual disease and a 96.5% complete response. The proposed recommendation for improvingoutcome is initiation of measurements for early detection of disease.