Radiation therapy of pelvic recurrence after radical hysterectomy for XXXX .

@entity1 @entity5 @entity957 @entity900 @entity2622 @entity420
OBJECTIVES: To evaluate the efficacy of radiation therapy and potential prognostic factors in @entity1 treated for pelvic recurrence of @entity2622 after radical hysterectomy. MATERIALS: The records of 50 @entity1 treated between 1964 and 1994 for an isolated pelvic recurrence of @entity2622 a median of 10.5 months after initial radical hysterectomy were retrospectively reviewed. @entity1 were categorized according to the extent of disease on clinical examination as group 1, mucosal involvement only (5); group 2, paravaginal extension (11); group 3, central recurrence with pelvic wall extension (13); and group 4, recurrences limited to the pelvic sidewall (21). Seven @entity1 with group 3 or 4 disease who had a poor performance status were treated with palliative intent using hypofractionated radiotherapy. The remaining 43 @entity1 were treated with curative intent, 33 with radiotherapy only and 10 with a combination of @entity900 -based chemotherapy and radiotherapy. Survival rates were calculated from the date of initial recurrence. Median follow-up of surviving @entity1 was 109 months. RESULTS: The overall 5-year survival rate was 33% for all 50 @entity1 (median survival, 18 months), 39% for the 43 @entity1 treated with curative intent, and 25% for @entity1 with isolated sidewall recurrences treated with curative intent. The survival rate was 69% for @entity1 with group 1 and 2 disease and 18% for those treated with curative intent for group 3 disease (P = 0.07). The survival rate was better for @entity1 with recurrent @entity957 (51%) than for those with @entity420 (14%) (P = 0. 05). Three group 4 @entity1 who survived more than 5 years were treated with external-beam radiation alone. Eight-one percent of @entity1 who had a second recurrence had evidence of disease progression. Three @entity1 experienced late treatment complications. CONCLUSIONS: @entity1 who experience an isolated recurrence of @entity5 after initial radical hysterectomy have an excellent prognosis if disease does not involve the pelvic wall. Occasional long-term survivors of recurrent disease involving the pelvic wall justify an aggressive treatment approach.
