Management of radiation injuries to the bowel associated with treatment of uterine carcinoma by radiotherapy: preliminary communication

Serious bowel complications developed in 12 patients out of a total of 200 treated for carcinoma of the cervix or endometrium at The Middlesex Hospital, London, between January 1974 and April 1977. Patients with carcinoma of the cervix received high-dose external radiotherapy to the whole pelvis supplemented by intracavitary Cathetron treatment. Most patients with endometrial carcinoma received intracavitary Cathetron therapy prior to extended hysterectomy, but a few inoperable cases received Cathetron therapy with additional external radiotherapy. Complications divided equally into cases of mainly rectosigmoid and mainly small bowel damage, although some patients had damage at both sites. None of the 94 patients receiving intracavitary Cathetron therapy alone suffered any bowel injury. The dose of external radiotherapy given in addition to Cathetron treatment should be reduced in vulnerable patients. Recommendations are made for the surgical management of these radiation injuries to the bowel. (U.K.)