An interstitial therapy for carcinoma of the cervix cases difficult to manage with standard intracavitary therapy

Certain carcinomas of the cervix are difficult to manage using standard intracavitary therapy because of significant vaginal narrowing, or an unidentified cervical os, or a carcinoma of the stump. Therefore, from July 1985 through December 1991, the authors have provided an interstitial therapy using radium needles for 6 cervical cancer cases manifesting such complications, consisting of 3 stage III patients and 3 stage IV (FIGO) patients, and report on their results. As expected, during the follow-up period that ranged from 10 to 45 months, locoregional control was excellent, and no complications were experienced with the interstitial implant. Of the 6 cases so treated, 2 of the stage III patients and 1 stage IV patient have survived and have maintained a disease-free status for over 3 years. The 3 other patients died: 2 from a distant metastasis and 1 from a major rectovaginal fistula radiation injury, this latter patient, after the initial radiotherapy, having again received radiotherapy as a secondary treatment for a late, local recurrence. Based on the above results, this interstitial therapy appears useful in improving local control and for improving chances of survival for cases that can not be managed with standard intracavitary therapy. (author)