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Treatment of stage IIIB carcinoma of the cervix. Improvement in local control by radium needles implant to supplement the dose to the parametrium
Author(s) -
Prempree Thongbliew,
Scott Ralph M.
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197809)42:3<1105::aid-cncr2820420311>3.0.co;2-4
Subject(s) - parametrium , medicine , parametrial , radium , cervix , pelvis , stage (stratigraphy) , cervical cancer , implant , surgery , brachytherapy , radiation therapy , nuclear medicine , cancer , cervical carcinoma , paleontology , physics , nuclear physics , biology
From 1971 to 1974 at the University of Maryland Hospital a total of 53 cases Stage III B cancer of the cervix (FIGO) were treated by a technique consisting of total pelvis irradiation (4000–5000 rad/4–5 weeks) plus a boost to the affected parametrium up to 5500 rad/5 1/2 weeks followed by usual Fletcher‐Suit intrauterine and vaginal radium. An overall absolute three year survival rate (NED) of 49% (26/53) was obtained. Local failure and especially parametrial failure was 51% (27/53). All local failure occurred within one year after the completion of the therapy. Further analysis showed that all local and parametrial failure cases at the time of radium insertion had evidence of residual disease in parametria as well as midline lesion under EUA. Because of the findings suggestive of inadequate radium dosage, a group of patients treated from 1975 to early 1976 who were diagnosed jointly by Gynecologic and Radiation Oncologists as Stage III B (FIGO) had a radium needle implant to the affected parametrium as a booster to the routine radium. Whole pelvis irradiation was given to 4000–5000 rad/4–5 weeks and pelvic wall boost to 5500 rad/5 1/2 weeks as usual prior to radium therapy. 18 cases of Stage IIIB cervical CA. were treated by radium needles implant in conjunction with protruding tandem and have had a careful follow‐up ranging from 15 months to 36 months. Fourteen of 18 cases treated in this fashion showed a complete disappearance of the neoplastic disease (14/18 = 78%). One case was lost to follow‐up and three cases showed local failure within 6 months after therapy (4/18 = 22%). Technique and dosimetry with less than expected complications will be discussed in detail.