Case report: high dose irradiation for recurrent carcinoma of the cervix following radical hysterectomy

A patient with recurrent carcinoma, after radical hysterectomy for Stage 1B carcinoma of the cervix, is presented to illustrate a technique for excluding the small bowel from high dose irradiation. With a barium meal and follow through examination, and fluoroscopy using the simulator, the ideal treatment position for the boost to high dose was determined. Consequently the patient received high dose irradiation with minimal complications and has survived for 42 months after treatment. Since a significant proportion of patients with recurrent carcinoma of the cervix have disease limited to the pelvis, many are potentially curable with high dose irradiation. Small bowel tolerance is a major dose limiting factor: the use of special techniques that limit the volume of small bowel receiving a high dose may enable these patients to have curative irradiation with minimal morbidity. (author)