Radiation therapy for cervical cancer: Late effects on life span and on leukemia incidence

Abstract

To investigate life-shortening after partial body exposure, survival of 497 patients whose primary treatment was exclusively with x-rays and radium for squamous cell cancer of the cervix (localized and regional stages) is under continuing study. To eliminate early deaths due to cancer and to provide maximal follow-up time, the group includes only those who survived at least 5 years and who were under age 55 at time of diagnosis. The patients were treated in 1932–1951 and were drawn from the University of California and Connecticut State Tumor Registries. Pelvic regional dose was calculated for each patient. Three dose-groups were formed: < 23 Mgm-rads, 23–31 Mgm-rads, and 32–54 Mgm-rads. When dose groups were compared with one another within stage and registry, and also after pooling stages and registries, no statistically significant differences in survival were found. When uterine cancer deaths were excluded to adjust for the possibility that unsuccessful treatment might have masked the life-shortening effect under study, again no association was found between radiation dosage and survival. In excess of 7 cases of leukemia were predicted for the 10-year period of 5 to 14 years after treatment. To this time, no deaths have been attributed to leukemia.