Radiotherapy for pelvic recurrence after radical hysterectomy for cervical cancer

Purpose: To evaluate outcomes in patients treated with irradiation for recurrent cervical cancer after hysterectomy. Methods: This is a retrospective chart review of 36 patients initially treated with a radical hysterectomy and lymph node dissection who developed a pelvic recurrence and were subsequently treated with irradiation. None received chemotherapy. Results: The overall 5- and 10-year survivals were 74% and 50%, respectively. Ten patients developed recurrent disease after irradiation. The sites of failure in these 10 patients were pelvis only in two, pelvis and distant metastases in five, and distant metastases only in three. Severe complications occurred in four patients. One patient developed a hip fracture, one developed a bowel obstruction requiring a colostomy, and two developed fistulae. Conclusion: Pelvic irradiation and brachytherapy resulted in a 74% overall 5-year survival. Distant metastases were the most common site of failure. Systemic chemotherapy should be considered as adjunctive therapy for these patients.