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.