TY - JOUR
T1 - Analysis of the severe complications of irradiation of carcinoma of the cervix
T2 - Whole pelvis irradiation and intracavitary radium
AU - Hamberger, Arthur D.
AU - Unal, Abdurrahman
AU - Gershenson, David M.
AU - Fletcher, Gilbert H.
N1 - Funding Information:
This work was supported in part by Grant CA06294 from the National Cancer Institute, Department of Health and Human Services, U.S.A. Reprint requests to: Arthur D. Hamberger, M.D. Accepted for publication 12 November 1982.
PY - 1983/3
Y1 - 1983/3
N2 - From January, 1967 to December, 1974, 325 patients with carcinoma of the uterine cervix were treated with a minimum of 4,000 rad whole pelvis irradiation plus intracavitary radium. These patients had large, sometimes massive, tumors. Generally, the larger the primary tumor the greater the amount of external irradiation delivered, with an appropriate reduction in the amount of intracavitary radium. Patients who had a positive lymphangiogram or a pre- or postirradiation hysterectomy or lymphadenectomy are not included in this analysis. All patients were followed for a minimum of 5 years. Local and regional failure rate in 193 patients receiving 4,000 rad whole pelvis irradiation plus radium was 1 % and 4%, respectively, with a 3.1 % incidence of severe complications. In 111 patients who received 5,000 rad whole pelvis irradiation plus radium, the local and regional failure rate was 3.5 % and 4.5 %, respectively, with a 10% incidence of severe complications. In patients who received 5,000 rad whole pelvis irradiation, complications were associated with unilateral parametrial boosts and with protruding vaginal sources. Of 21 patients who received 6,000 rad whole pelvis irradiation, three patients developed fistulae associated with high doses to the vagina delivered with protruding vaginal sources.
AB - From January, 1967 to December, 1974, 325 patients with carcinoma of the uterine cervix were treated with a minimum of 4,000 rad whole pelvis irradiation plus intracavitary radium. These patients had large, sometimes massive, tumors. Generally, the larger the primary tumor the greater the amount of external irradiation delivered, with an appropriate reduction in the amount of intracavitary radium. Patients who had a positive lymphangiogram or a pre- or postirradiation hysterectomy or lymphadenectomy are not included in this analysis. All patients were followed for a minimum of 5 years. Local and regional failure rate in 193 patients receiving 4,000 rad whole pelvis irradiation plus radium was 1 % and 4%, respectively, with a 3.1 % incidence of severe complications. In 111 patients who received 5,000 rad whole pelvis irradiation plus radium, the local and regional failure rate was 3.5 % and 4.5 %, respectively, with a 10% incidence of severe complications. In patients who received 5,000 rad whole pelvis irradiation, complications were associated with unilateral parametrial boosts and with protruding vaginal sources. Of 21 patients who received 6,000 rad whole pelvis irradiation, three patients developed fistulae associated with high doses to the vagina delivered with protruding vaginal sources.
KW - Cervical cancer
KW - Complications of irradiation
UR - http://www.scopus.com/inward/record.url?scp=0020593905&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0020593905&partnerID=8YFLogxK
U2 - 10.1016/0360-3016(83)90298-5
DO - 10.1016/0360-3016(83)90298-5
M3 - Article
C2 - 6404869
AN - SCOPUS:0020593905
SN - 0360-3016
VL - 9
SP - 367
EP - 371
JO - International journal of radiation oncology, biology, physics
JF - International journal of radiation oncology, biology, physics
IS - 3
ER -