Intraoperative radiotherapy in stage IIB adenocarcinoma of the uterine cervix: a retrospective study

OBJECTIVES: Adenocarcinoma (AC) of the uterine cervix has a poor prognosis and is usually fatal. The aim of this study was to evaluate the clinical outcome and toxicity of intraoperative electron beam radiation therapy (IOERT) in advanced AC. METHODS: Twenty-seven women were treated with IOERT. Surgery consisted of gross negative surgical margins in 19 patients, positive surgical margins in two patients, and close surgical margins in six patients. Twenty-three patients received chemotherapy. RESULTS: The 5-year overall survival and disease-free survival rates were 21/27 (77.8%) and 19/27 (70.4%), respectively. A significantly better survival rate was found in patients with AC compared to patients with adenosquamous carcinoma. Tumor recurrence and metastasis were observed in seven patients (25.9%). No central failure occurred whether or not the resection margins were positive. Two (7.4%) patients developed peripheral neurotoxicity. CONCLUSION: IOERT plus surgery may be feasible and effective with a low risk of toxicity, even in patients with positive resection margins.