Remote afterloading high dose rate intracavitary therapy for carcinoma of the uterine cervix, 1

From August 1978 through December 1982, a total of 200 patients of previously untreated carcinoma of the uterine cervix (intact uterus) were treated by using RALS, remote afterloading high dose rate intracavitary therapy at our department. According to the staging of UICC (1978), 8 patients were classified into Stage Ia, 11 Ib, IIa, 53 IIb, 85 III and 10 IV. Actuarial 5 year survival rates by stage were 100 % in Stage Ia, 86 % Ib, 67 % IIa, 72 % IIb, 41 % III and 20 % IV. A significant prognostic factor in Stage II was the value of hemoglobin (p < 0.02). Corresponding figures in Stage III were the value of hemoglobin (p < 0.02), total protein (p < 0.02), mgh (p < 0.03) and age ( < 0.05). A total of 63 patients (32 %) were dead from tumor (DT), 15 (8 %) intercurrent diseases and 6 (3 %) unknown causes. There was a correlation between the advance of stage and the increase of DT. Forty-five patients developed distant metastases (23 %), 35 central and/or peripheral recurrence (18 %) and 25 paraaortic lymph node metastases (13 %). There was a close correlation between the incidence of distant metastases and central and/or peripheral recurrence and the advance of stage. However, the incidence of paraaortic lymph node metastases was not in close correlation. Late complications after RALS were developed in 22 patients (11 %), i.e., rectum 14 (7 %), bladder 6 (3 %), small intestine 4 (2 %) and sigmoid colon 1 (1 %). Severe complications requiring surgery were noted in 7 cases (4 %). There was no fatal case attributable to complication. It is concluded that RALS is one of the most effective and safe means for the treatment of carcinoma of the uterine cervix under careful dose monitoring system on our results. (author)