Gastrointestinal complications caused by high-dose-rate intracavitary irradiation for carcinoma of the uterine cervix

We treated 64 patients with carcinoma of the uterine cervix with high-dose-rate intracavitary irradiation between 1978 and 1984. Of the 52 patients who were followed for more than two years, gastrointestinal complications occurred in 11 (21 %): six grade I patients (12 %), two grade II patients (4 %) and three grade III patients (6 %). The patients were graded according to the severity of the complications. The three patients with grade III complications underwent emergency surgery because of ileus or perforation of the gastrointestinal tract. It is suggested that these severe complications are liable to occur in patients given more than seven fractions of intracavitary irradiation in a fraction dose of 6 Gy to point A or previously operated on in the pelvic cavity. Accurate center shield in relation to tandem sources is also emphasized. (author)