Radiotherapy for Centrally Recurrent Cervical Cancer of the Vaginal Stump Following Hysterectomy

Positron emission tomography/computerised tomography imaging in detecting and managing recurrent cervical cancer: systematic review of evidence, elicitation of subjective probabilities and economic modelling

“…[86][87][88]90,92 In Hille et al, 86 grade 3 late toxicity was observed in 8% of patients, including intestinal bleeding after 7 months and fistulae between the rectosigmoid colon and the vagina, removed subsequently by surgery. In Ito et al, 87 late complications of radiotherapy, including intestinal and urinary complications of grade 2 and grade 3, occurred in 32% of patients.…”

“…Patients with pelvic side wall recurrences were found to have poorer prognoses than patients with central recurrences only (range 2-15% and 42-82%, respectively, for 5-year survival). Data for 10-year overall survival were provided in Ito et al, 87 with a 52% rate for patients with centrally recurrent tumours of the vaginal stump following hysterectomy for cervical cancer. Additionally, they showed that survival was greatly influenced by the tumour size of the vaginal stump so that the 10-year survival rate of patients with small-sized tumours was 72%, whereas the corresponding survival rate of patients with medium-sized tumours was 48% (Table 44).…”

“…The interventions are radiotherapy or radiotherapy with chemotherapy (chemoradiotherapy). The search for relevant studies did not identify any RCTs but 16 case series met the inclusion criteria: nine evaluated radiotherapy [84][85][86][87][88][89][90][91][92] and seven evaluated chemoradiotherapy. [93][94][95][96][97][98][99] The results of the quality assessment for the radiotherapy and chemoradiotherapy studies are presented in Appendix 15.…”

“…Most of the nine case series [84][85][86][87][88][89][90][91][92] included a small number of patients (median 82 cases, range 18-130 cases). Study locations included the UK, the USA, Japan, the Netherlands and Germany.…”

“…Study locations included the UK, the USA, Japan, the Netherlands and Germany. The majority of women presented with early-stage cervical cancer, but in three studies 86,87,91 there was no information about FIGO stage. The proportion of patients with recurrent or persistent disease in the pelvis as the only site of cancer (central recurrence) was lower than the proportion developing distant metastases.…”