Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer
August 23, 1997
Does treatment with surgery or RT improve survival for women with early stage cervical cancer?
class III radical hysterectomyadjuvant RT (5040cGy) if - >stage IIA, <3mm uninvolved cervical stroma, cut-through, LN mets
EBRT 4700cGy + brachytherapy (point A dose 7600cGy)
newly diagnosed stage IB or IIAage 30-70 yrs
surgery (n=170) vs RT (n=167):64% of surgery pts received adjuvant RTmedian f/u: 87 mos5yr PFS: 74% vs 74% (NS)5yr OS: 83% vs 83% (NS)5yrs OS adeno: 70% vs 59% (SS)grade 2/3 toxicity: 28% vs 12% (SS)
There is no treatment of choice for early stage cervical cancer. The combination of surgery and RT carries the highest morbidity