Cancer Research and Treatment

Original Articles

Results of Curative Radiotherapy Alone in Patients with Uterine Cervical Carcinomas: Taek Keun Nam, Byung Sik Nah, Sung Ja Ahn, Woong Ki Chung, Ho Seon Choi, Yoon Kyeong Oh; Cancer Res Treat. 2002;34(5):365-371. Published online October 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.5.365

Abstract PDF: PURPOSE
To evaluate the role of curative radiotherapy alone in the treatment of uterine cervical carcinomas, by a retrospective analysis with respects to survival and pelvic control, and to find any risk factors of failure MATERIALS AND METHODS: Between Jan. 1990 and Dec. 1995, a total of 187 patients, diagnosed with uterine cervical carcinomas in FIGO stages greater than IA, were treated by curative radiotherapy alone with no chemotherapy. The ages of the patients ranged from 26 to 80 years, with a median of 60 years. The number of patients diagnosed with squamous cell carcinomas were 183 (97.9%). The number of patients with FIGO stage IB1, IB2, IIA, IIB, IIIA, IIIB and IVA were 61 (32.6%), 7 (3.7%), 43 (23.0%), 62 (33.3%), 3 (1.6%), 7 (3.7%) and 4 (2.1%), respectively. External radiotherapy was performed with 6 MV or 10 MV X-rays, with a dose range of 19.8 Gy~ 50.4 Gy (median; 30.6), to whole pelvis. Intracavitary radiation (ICR) was then performed using a high-dose rate remote controlled afterloader with radioisotopes of Co-60 and Cs-137. The fraction size of the ICR was 5 Gy twice a week, and was delivered up to total doses of 10 Gy~ 55 Gy (median; 40). After the ICR, additional pelvic external radiotherapy with midline shielding width of 4 cm was performed with the dose range of 0~30.6 Gy (median; 19.8), and the resultant total doses of A points ranged between 49.8 Gy and 86.0 Gy (median; 70.6).
RESULTS
The five-year overall survival rates of FIGO IB1, IB2, IIA, IIB, III and IVA were 88.3%, 83.3%, 86.1%, 65.2%, 60.0% and 50.0%, respectively (p=0.005). The pelvic control rates of each stage were 90.1%, 85.7%, 86.1%, 69.4%, 68.6% and 50.0%, respectively (p=0.03). From the multivariate analysis, the radiation response and tumor diameter were found to be significant factors affecting the overall survival. The significant factors influencing pelvic control were the radiation response and pre-treatment hemoglobin level.
CONCLUSION
The radiation response and tumor diameter were significant factors affecting survival, so patients with tumor diameters greater than 4 cm should be considered for a combined modality, such as concurrent chemoradiotherapy.

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p16INK4A and p15 INK4B Gene Alterations in Primary Uterine Cervical Carcinoma Tissues and Cervical Carcinoma Cell Lines: Sun Won Yoo, Jin Woo Kim; J Korean Cancer Assoc. 1998;30(5):1044-1052.

Abstract PDF: PURPOSE
Alterations of the p15(INK4B) and p16(INK4A) gene which are separated by 25 kb on chromosome 9p21 have been reported in various tumor derived cell lines and primary tumors, but the role of these genes in cervical cancer is unknown. MATERIAL AND METHOD: To determine the frequency of deletions and point mutations of these genes in human cervical cancer, we examined 57 primary tumors and matched normal tissues, and 3 cervical cancer derived cell lines. All the tumor tissues and cell lines were human papil- INK48 lomavirus (HPV)-positive. Deletions or point mutations of exon 2 of the pl5 gene and exons 1, 2, and 3 of the p16(INK4A) gene were examined by polymerase chain reaction (PCR) and direct sequencing, respectively.
RESULT
Our data indicate no evidence for intragenic homozygous deletion or point mutation in the cervical cancer or cervical cancer derived cell lines. INK48 INK4A CONCLUSION: Deletions or point mutations in the p15 or p16 gene may not be required for the development of HPV-positive cervical cancer or for establishment of cervical cancer cell lines.

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