Experiencia del Instituto Regional de Tratamiento del Cáncer en el manejo del cáncer cervicouterino con radioterapia

Abstract

Background

Cervical uterine cancer (CUC) is an important public health problem in our country. The treatment of this cancer depends on the clinical stage. The therapeutic modalities used may be surgery, radiotherapy, and a combination of radiotherapy plus chemotherapy.

Objective

To describe the experience of the Regional Institute of Cancer Treatment (RICT) in patients with cervical cancer treated with external radiotherapy plus brachytherapy with iridium 192.

Method

A descriptive, retrospective study was conducted on 32 patients with cervical uterine cancer treated by external radiotherapy with linear accelerator, a 5000 dose of cGy (isocentric technique) plus 2100 cGy with high dose rate (HDR) brachytherapy in 3 sessions. Patients with clinical stage IA2 were treated only with brachytherapy, with a minimum follow-up of 2 years.

Results

There were 2 patients in stage IA2, 7 in stage IB1-IB2, 1 patient in IIA, 11 patients in IIB, 8 in stage IIIB, 1 patient in stage IVA 1, and 2 patients unclassified. Only 3 patients (2 in stage IIB, and 1 in stage IIIB) were treated with concomitant chemotherapy. Immediate morbidity was grade II cystitis in 3 patients and grade III proctitis in 3 patients. The delayed morbidity included grade II proctitis in 3 patients, grade I cystitis in 3 patients, partial synechiae in 5 patients, and complete synechiae in 4 patients. Twenty-three patients survived with no tumour activity, which included, brachytherapy only in 2 in stage IA, 7 in IB1-IB2, 1 in IIA, 7 in stage IIB, 4 in stage IIIB, 1 in stage IVA, and 1 in unclassified. Of the 9 patients that died, 4 were in stage IIB, 4 in stage IIIB, and 1 unclassified.

Conclusion

Locoregional control and survival are similar to those reported in the literature, but with less morbidity.