THE EFFECTS OF TREATMENT PROLONGATION AND GAP POSITION ON OUTCOME OF CERVICAL CARCINOMA PATIENTS TREATED BY PRIMARY RADIOTHERAPY

Between 1985-1995, 154 patients with stage I-IVA cervical carcinoma who were treated by definitive radiotherapy were analyzed retrospectively to evaluate the effect of total treatment time prolongation and gap position on treatment results. All of the patients received 50 Gy/28 fractions by external radiotherapy (ERT) followed by 20 Gy intracavitary brachytherapy. Gaps' position during ERT were investigated in four cathegories: early gaps were in the first 1/3 treatment duration; middle gaps were in the second 1/3 days; late gaps were in the last 1/3 and scattered gaps were distributed irregularly. A nearly significant decrease in overall survival (OS) (P=0.06) and a significant decrease in local disease free survival (LDFS) (P=0.03) and a nearly significant increase in local relaps (LR) (P=0.06) were demonstrated as the gaps duration prolonged. Gaps position during ERT was also evaluated and it was found that gap position was more detrimental than gap duration on OS, LDFS and LR. The treatment results of the patients were similar in the two groups with no gap and middle gap (OS %74.6, %79; LDFS %77.3, %75.4 LR %22, %22, respectively). In the late gap and scattered gap groups, the results were the worst (OS %20, %27.5; LDFS %40, %24, LR %52, %57, respectively). We found significant effect of treatment prolongation and gap position on OS, LDFS and LR in cervical carcinoma patients treated by definitive radiotherapy.