Brachytherapy with cathetron - clinical experience

All stages through stage I of carcinoma uterine cervix of 805 cases were given radiotherapy. The whole pelvis was irradiated, without central shielding, by three or four field arrangement. This treatment was supplemented by intracavitary radiotherapy with cathetron using 60Co. Different fractionation schedules were used for external radiotherapy and intracavitary radiotherapy with cathetron. The treatment with cathetron is spread over five days. As no significant difference in rectal and bowel problems was found between the groups treated with two fractions and three fractions using cathetron, all patients are now treated with two fractions, 1258 rad/fraction. In the case of external radiotherapy, 5 weekly fractionation (610 rad/fraction) has been adopted as a routine in preference to daily fractionation 230 rad/fraction spread over 5 days a week for four weeks as there was no significant difference in local response and bowel reactions in both groups. Biopsies showed acute mucosal damage during and immediately after treatment which showed regression during the sixth week after treatment. After six months, mucosa almost returns to normal. The mucosal pattern was also found to be normal at three, four and five years after treatment. (M.G.B.)