Introduction/Background Intraoperative radiation therapy (IOERT) is a treatment that combines surgery and radiotherapy. It’s been reported in the treatment of gastric cancer, pancreatic cancer and other disease by giving a large dose of radiation to the target area during the operation.
Methodology 427 patients with cervical carcinoma underwent radical radiotherapy from January 1997 to December 1999 in the First Affiliated Hospital of Xi’an Jiaotong University. Among them, 92 patients with stage IIB (FIGO1985) accepted preoperative radiotherapy EQD220–30 Gy (including external beam radiotherapy with 6MV X-ray 10–20Gy/5–10f to pelvic field and/or brachytherapy with 7–21Gy/1–3f to point A), After 1 week‘s interval, patients completed total hysterectomy plus double accessory resection(without pelvic lymph node dissection) + IOERT with 12 MeV electron beam 18–20 Gy to pelvic field (We have the patent of China for the special applicator used in IEORT.). Patients were discharged from hospital 7 days after surgery and were followed up regularly. Patients didn’t receive concurrent chemotherapy. The total treatment time was 4 weeks.
Results The 20-year survival rate was 85.9%. 3 patients lost follow-up were considered dead. Metastasis was observed in 11 patients (11.9%) (table 1), 10 patients died of metastasis and 1 patient had vaginal metastasis 13 years after treatment, but achieved a long-term survival after retreatment. Local recurrence was not found. The major complication was hydronephrosis, which occurred in 15 patients (16.3%), including 7 patients with grade 2, whose renal function returned to normal after double J ureteral stents treatment. Other toxicities such as radiation proctitis, radiation cystitis and myelosuppression were shown in table 2.
Conclusion The application of total hysterectomy plus double accessory resection combined with IOERT in patients with cervical cancer IIB can obtain good therapeutic effects with acceptable toxicities and shorten the treatment time.
Disclosure No potential conflicts of interest were disclosed.
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