병기 2b 자궁경부암의 방사선 치료에서 온열치료 병용의 원격전이에 대한 영향 및 관련인자 분석 = Effect of Addition of Hyperthermia on Distant Metastasis and Associated Factor Analysis in Radiotherapy of Stage 2b Uterine Cervical Cancer

다국어 초록 (Multilingual Abstract)

Background/Objective : This retrospective study was conducted to analyze effect of addition of hyperthermia on distant metastasis and to determine factor affecting distant metastasis in radiotherapy of stage 2b uterine cervical cancer.
Methods : From May 1992 to Dec. 1996, among patients treated with radio-thermotherapy in stage 2b uterine cervical cancer at department of Radiation Oncology in Kosin Medical College, 25 patients without evidence of distant metastasis in initial work-ups by physical examination, computed tomography, magnetic resonance imaging, ultrasonography and radioisotope scan were enrolled. The range of age was 33-71 years (median : 52). Radiotherapy used 6-10 MV linear accelerator was performed in whole pelvis with 4 portals technique. Total dose administered was 50-125.5 Gy (median: 77.24) with external irradiation alone or combined with intracavitary brachytherapy by conventional (200 rads/ fraction, 5 fr./week) or hyperfractionated (120-135 rads/ fr., 2fr./day, 10 fr. / wk) methods. Hyperthermia used 8 MHz radiofrequency capacitive heating device (CANCERMIA, Green-Cross Corp.) was applied in pelvic area with 2-3 sessions / week, 40-60 minute / session within 15-20 minute after radiotherapy. The range of power was 800-1300 Watt and 2.7-3.5 kv in kvp. Measurement of intratumoral temperature used Teflon-coated cooper constantans microthermocouple was done with once per 2 weeks. Eleven patients (44%) were received heating less than 7 sessions and 14 (56%) were more than 8 sessions. Statistics was calculated with logistic regression model in SPSS for window and significance was Chi-square test. Duration of follow-up was 9-75 months (median : 36).
Results : Distant metastasis were found in 8 patients (32%). Among 8 patients, 4 revealed distant metastasis only and 4 showed distant metastasis with locoregional failure. The sites of distant metastasis were retroperitoneal lymph node (3 patients), bone (3), peritoneal cavity (2), supraclavicular lymph node (2), liver (1), brain (1) and lung (1). In univariate and multivariate analyses, there was no significant factor affecting distant metastasis.
Conclusions : There were no evidence of increase of distant metastasis by radio-thermotherapy compared to radiotherapy alone in stage 2b uterine cervical cancer.